Organization
QUEENS MANOR HOME CARE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JANE TACAY TOTANES LVN (ADMINISTRATOR/LICENSEE)
(760) 716-9301
Entity
Organization
Contact information
Practice address
1025 BONNIE BRAE PL, VISTA, CA 92084-5529
(760) 806-9455
(760) 806-9455
Mailing address
1025 BONNIE BRAE PLACE, VISTA, CA 92084
(760) 216-8024
(760) 806-9455
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
374603285
CA
Other
Enumeration date
08/22/2013
Last updated
10/02/2014
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