Organization
EVERETT FOREST,LLC
Active
Other names
ASSISTED LIVING-RCFE/HOSPICE
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELO SWANSON GALASINAO ADMINISTRATOR (LICENSEE AND ADMINISTRATOR)
(909) 799-3170
Entity
Organization
Contact information
Practice address
11350 POPLAR ST, LOMA LINDA, CA 92354-3519
(909) 799-3170
(909) 799-1381
Mailing address
11350 POPLAR ST, LOMA LINDA, CA 92354-3519
(909) 799-3170
(909) 799-1381
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
366410695
CA
Other
Enumeration date
11/04/2016
Last updated
01/27/2017
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