Organization
CANAAN HOME INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROMEO GARDON LABSTIDA (ADMINISTRATOR)
(714) 206-1964
Entity
Organization
Contact information
Practice address
10904 ARIZONA AVENUE, RIVERSIDE, CA 92503-5902
(951) 343-9197
(951) 808-7116
Mailing address
10904 ARIZONA AVENUE, RIVERSIDE, CA 92503-5902
(951) 343-9197
(951) 808-7116
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
09/07/2022
Last updated
09/07/2022
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