Organization
AMAZING GRACE OASIS II
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EILEEN ANDREASYAN PHARMD (ADMINISTRATOR)
(818) 572-3956
Entity
Organization
Contact information
Practice address
8708 BRIDGEPORT AVE, HESPERIA, CA 92344-5562
(818) 572-3956
(818) 925-3011
Mailing address
8708 BRIDGEPORT AVE, HESPERIA, CA 92344-5562
(818) 572-3956
(818) 925-3011
Taxonomy
Speciality
Code
Description
License number
State
310500000X
Mental Illness Intermediate Care Facility
Primary
—
—
Other
Enumeration date
11/07/2018
Last updated
11/07/2018
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