Organization
D' VINE HOME
Active
Parent organization
GLECO LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
GLECO LLC
Authorized official
MRS. CONCEPCION GABRIEL PANOPIO (ADMINISTRATOR)
(760) 371-5153
Entity
Organization
Contact information
Practice address
16123 VINE ST, HESPERIA, CA 92345-3113
(760) 981-4595
(760) 981-4501
Mailing address
18101 JUNIPER ST, HESPERIA, CA 92345-6324
(760) 981-4595
(760) 981-4501
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
366412235
CA
Other
Enumeration date
05/07/2010
Last updated
05/07/2010
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