Organization
FILLMORE COUNTRY CLUB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENQ H CHEN (CHAIRMAN/PRESIDENT)
(310) 889-9929
Entity
Organization
Contact information
Practice address
827 RIVER ST, FILLMORE, CA 93015-1818
(805) 524-7979
Mailing address
1937 PONTIUS AVE, LOS ANGELES, CA 90025-5611
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
06/20/2013
Last updated
06/20/2013
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