Organization
AMAZING GRACE OASIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EILEEN ANDREASYAN (ADMINISTRATOR)
(818) 572-3956
Entity
Organization
Contact information
Practice address
13842 LEMONGRASS WAY, HESPERIA, CA 92344-0042
(818) 572-3956
(760) 983-5616
Mailing address
13842 LEMONGRASS WAY, HESPERIA, CA 92344-0042
(818) 572-3956
(760) 983-5616
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Enumeration date
01/09/2018
Last updated
01/09/2018
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