Organization
GERI-CARE IV, LLC
Active
Other names
Antelope Valley Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD L TERRELL MBA (ADMINISTRATOR)
(661) 949-5524
Entity
Organization
Contact information
Practice address
44567 15TH ST W, LANCASTER, CA 93534-2803
(661) 949-5524
(661) 949-5140
Mailing address
44567 15TH ST W, LANCASTER, CA 93534-2803
(661) 949-5524
(661) 949-5140
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
920000122
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LTM90003G
—
CA
Enumeration date
11/09/2005
Last updated
12/19/2011
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