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Organization

EASTVALE CONGREGATE CARE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. LESLEY SIHAVONG VANNOY (CEO/ OWNER)
(951) 847-5476
Entity
Organization

Contact information

Practice address
6764 BLACK FOREST DR, EASTVALE, CA 92880-3922
(951) 268-2150
(951) 479-5260
Mailing address
6764 BLACK FOREST DR, EASTVALE, CA 92880-3922
(951) 268-2150
(951) 479-5260

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary

Other

Enumeration date
08/14/2018
Last updated
04/27/2022
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