Organization
DELLBROOK GUEST HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LESLEY VANNOY (ADMIN)
(951) 847-5476
Entity
Organization
Contact information
Practice address
13731 DELLBROOK ST, EASTVALE, CA 92880-5521
(951) 847-5476
Mailing address
13731 DELLBROOK ST, EASTVALE, CA 92880-5521
(951) 847-5476
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
336425136
CDSS
CA
Enumeration date
11/05/2020
Last updated
04/27/2022
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