Organization
HARVESTMOON ICFDDN
Active
Other names
Carequest
Organization subpart
No
Provider details
NPI number
Authorized official
MS. YOLIE CRUME R.N. (ADMINISTRATOR-OWNER)
(626) 665-8938
Entity
Organization
Contact information
Practice address
1017 E HARVEST MOON ST, WEST COVINA, CA 91792-1023
(626) 665-8938
(925) 516-7106
Mailing address
1017 E HARVEST MOON ST, WEST COVINA, CA 91792-1023
(626) 665-8938
(925) 516-7106
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
960001418
CA
Other
Enumeration date
06/01/2007
Last updated
06/19/2008
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