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Organization

JLAB INC

Active
Other names
CASA MIA
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. LILIBETH SAMSON (OWNER, ADMINISTRATOR)
(951) 264-7933
Entity
Organization

Contact information

Practice address
10650 54TH STREET, MIRA LOMA, CA 91752-2231
(951) 685-9000
(951) 685-9000
Mailing address
10650 54TH STREET, MIRA LOMA, CA 91752-2231
(951) 685-9000
(951) 685-9000

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary

Other

Enumeration date
02/26/2020
Last updated
02/26/2020
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