Organization
MAGNOLIA GUEST HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GENE LOBATON GEPULLE JR. (ADMINISTRATOR)
(925) 642-0427
Entity
Organization
Contact information
Practice address
1639 FAIRWOOD DR, CONCORD, CA 94521
(925) 642-0427
Mailing address
292 ROYCE WAY, PITTSBURG, CA 94565-4700
(925) 427-9070
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
079200401
CA
Other
Enumeration date
05/05/2015
Last updated
09/13/2019
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