Organization
MONDELL PINE MANOR I
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEROME VIRAY (LICENSEE)
(818) 332-6150
Entity
Organization
Contact information
Practice address
39046 MONDELL PINE AVE, PALMDALE, CA 93551-6042
(818) 332-6150
(805) 578-9486
Mailing address
1716 ERRINGER RD STE 104, SIMI VALLEY, CA 93065-6506
(818) 332-6150
(805) 578-9486
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
07/11/2024
Last updated
07/11/2024
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