Organization
SECROM INC
Active
Other names
Carson Senior Assisted Living
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOE GOLDMAN (ADMINISTRATOR)
(310) 830-4010
Entity
Organization
Contact information
Practice address
345 E CARSON ST, CARSON, CA 90745-2709
(310) 830-4010
(310) 835-3998
Mailing address
345 E CARSON ST, CARSON, CA 90745-2709
(310) 830-4010
(310) 835-3998
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
198204950
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
278.2604
198207950
CA
Enumeration date
07/18/2013
Last updated
07/18/2013
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