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Organization

EAGLE CREST ASSISTED LIVING HOME, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LATONIA WILSON (LICENSEE)
(951) 484-5960
Entity
Organization

Contact information

Practice address
35111 TAVEL ST, WINCHESTER, CA 92596-4512
(951) 484-5960
Mailing address
35111 TAVEL ST, WINCHESTER, CA 92596-4512
(951) 484-5960

Taxonomy

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

Other

Enumeration date
09/25/2023
Last updated
09/25/2023
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