Organization
CRYSTAL CARE VILLA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHIRLEY MAGNO (LICENSEE / OWNER)
(626) 255-6659
Entity
Organization
Contact information
Practice address
6410 EL REPOSO STREET, JOSHUA TREE, CA 92252-2352
(760) 366-3845
Mailing address
6410 EL REPOSO STREET, JOSHUA TREE, CA 92252-2352
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
08/05/2014
Last updated
08/05/2014
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