Organization
CRYSTAL GARDEN RCFE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAMAL EBADPOUR (ADMINISTRATOR)
(213) 999-0995
Entity
Organization
Contact information
Practice address
13224 IROQUOIS RD, APPLE VALLEY, CA 92308-6384
(213) 999-0995
Mailing address
13224 IROQUOIS RD, APPLE VALLEY, CA 92308-6384
(213) 999-0995
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
08/04/2022
Last updated
08/04/2022
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