Organization
ST, GRACE HOSPICE, INC.
Active
Other names
ST. GRACE MANOR 2
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHLEEN JANET HAYWOOD (ADMINISTRATOR)
(951) 545-4462
Entity
Organization
Contact information
Practice address
4440 FAUNA ST, MONTCLAIR, CA 91763-3523
(951) 545-4462
Mailing address
4440 FAUNA ST, MONTCLAIR, CA 91763-3523
(951) 545-4462
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
—
—
Other
Enumeration date
11/07/2016
Last updated
11/07/2016
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