Organization
LILLIANNA RESIDENTIAL HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHIZUKO KAMIYAMA ALTEMUS (CAREPROVIDER)
(951) 780-3924
Entity
Organization
Contact information
Practice address
2051 RANCHO DR, RIVERSIDE, CA 92507-5841
(951) 780-3924
Mailing address
PO BOX 53264, RIVERSIDE, CA 92517-4264
(951) 780-3924
(951) 780-7515
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
336400918
CA
Other
Enumeration date
07/30/2009
Last updated
07/30/2009
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