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Organization

COBBLE CREEK CONGREGATE LIVING LLC

Active
Other names
Cobble Creek Congregate Living
Organization subpart
No

Provider details

NPI number
Authorized official
MARC TANG ADMINISTRATOR (CEO)
(949) 235-6269
Entity
Organization

Contact information

Practice address
7462 COBBLE CREEK DR, EASTVALE, CA 92880-3183
(949) 922-7713
Mailing address
12672 LIMONITE AVE STE 3E-123, EASTVALE, CA 92880-4201
(949) 922-7713

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary

Other

Enumeration date
11/04/2024
Last updated
11/04/2024
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