Organization
ABUNDANT GRACE SENIOR CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT LEE WARE (DIRECTOR)
(562) 275-2888
Entity
Organization
Contact information
Practice address
3830 W AGUA FRIA DR, GOLDEN VALLEY, AZ 86413-9309
(562) 275-2888
Mailing address
10650 REAGAN ST UNIT 1531, LOS ALAMITOS, CA 90720-8882
(562) 275-2888
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Enumeration date
10/19/2020
Last updated
10/19/2020
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