Organization
RIVERSIDE ELITE ADVANTAGE CARE HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMIE TENG (NURSING ADMINISTRATOR MANAGER)
(951) 850-1088
Entity
Organization
Contact information
Practice address
17085 BIRCH HILL RD, RIVERSIDE, CA 92504-8823
(951) 398-7680
Mailing address
31491 SHADOW RIDGE DR, MENIFEE, CA 92584-8213
(951) 850-1088
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
376G00000X
Nursing Home Administrator
—
—
Other
Enumeration date
08/05/2019
Last updated
11/23/2021
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