Organization
JACKY & ANGIE RESIDENTIAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. EVANGELINE B JOHNSON (ADMINSTRATRATOR)
(562) 925-7527
Entity
Organization
Contact information
Practice address
9332 GREENWELL ST, BELLFLOWER, CA 90706-3411
(310) 613-4211
Mailing address
9332 GREENWELL STREET, BELLFLOWER, CA 90706
(310) 613-4211
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
304006088
CA
Other
Enumeration date
04/16/2012
Last updated
04/16/2012
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