Organization
BLISSFUL JACKSON FACILITY LLC
Active
Organization
BLISSFUL JACKSON FACILITY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEN CLAVIO (CEO)
(310) 729-3844
Entity
Organization
Contact information
Practice address
4105 JACKSON ST, RIVERSIDE, CA 92503-3911
(310) 729-3844
Mailing address
4105 JACKSON ST, RIVERSIDE, CA 92503-3911
(310) 729-3844
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
11/06/2024
Last updated
11/09/2024
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