Organization
EVELYN LAVERN THOMPSON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EVELYN LAVERN THOMPSON (L.V.N)
(951) 485-6847
Entity
Organization
Contact information
Practice address
12279 LASSELLE ST, MORENO VALLEY, CA 92557-7705
(951) 485-6847
Mailing address
12279 LASSELLE ST, MORENO VALLEY, CA 92557-7705
(951) 485-6847
Taxonomy
Speciality
Code
Description
License number
State
3140N1450X
Pediatric Skilled Nursing Facility
Primary
VN129832
CA
Other
Enumeration date
01/25/2008
Last updated
01/25/2008
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