Organization
PHV 6 RCFE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICKOLAS LACSON (LICENSEE)
(714) 519-5878
Entity
Organization
Contact information
Practice address
14515 LUNA RD, VICTORVILLE, CA 92392-9486
(714) 519-5878
Mailing address
14515 LUNA RD, VICTORVILLE, CA 92392-9486
(714) 519-5878
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
03/29/2025
Last updated
03/29/2025
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