Organization
MAXICARE SENIOR HOME, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TEODULO BONZON (MANAGER)
(818) 846-4469
Entity
Organization
Contact information
Practice address
44523 15TH ST W, LANCASTER, CA 93534-2847
(818) 846-4469
Mailing address
3013 ANNITA DR, GLENDALE, CA 91206-1302
(818) 846-4469
(818) 457-5577
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
12/30/2019
Last updated
12/30/2019
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