Organization
BUENA VISTA AL, LLC
Active
Other names
Buena Vista Assisted Living
Organization subpart
No
Provider details
NPI number
Authorized official
RODDY RADNIA (MANAGER)
(310) 435-0797
Entity
Organization
Contact information
Practice address
1393 S BUENA VISTA ST, HEMET, CA 92543-7660
(951) 658-5160
Mailing address
8306 WILSHIRE BLVD # 135, BEVERLY HILLS, CA 90211-2304
(310) 435-0797
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
331880902
CA DEPARTMENT OF SOCIAL SERVICES
CA
Enumeration date
06/19/2020
Last updated
06/19/2020
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