Organization
MATTHEW 2540 LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEVIN LAWRENCE ANDERSON II (MEMBER/MANAGER)
(951) 235-6507
Entity
Organization
Contact information
Practice address
134 W MANFIELD ST, RIVERSIDE, CA 92507-4852
(951) 216-3326
Mailing address
20122 DAYTON ST, RIVERSIDE, CA 92508-6301
(951) 235-6507
Taxonomy
Speciality
Code
Description
License number
State
177F00000X
Lodging Provider
Primary
—
—
Other
Enumeration date
09/18/2024
Last updated
09/18/2024
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