Organization
ETERNITY CARE HOME 2
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA PETALLO PAYLA ADMINISTRATOR (LICENSEE)
(209) 450-7283
Entity
Organization
Contact information
Practice address
518 W GRANGER AVE, MODESTO, CA 95350-4255
(209) 450-7283
(209) 567-2761
Mailing address
518 W GRANGER AVE, MODESTO, CA 95350-4255
(209) 450-7283
(209) 567-2761
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
04/30/2026
Last updated
04/30/2026
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