Organization
EAGLE GLEN CARE HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RESTITUTO CALILUNG (LICENSEE)
(714) 906-6046
Entity
Organization
Contact information
Practice address
1697 HONORS CIR, CORONA, CA 92883-0757
(951) 582-9230
(951) 340-2740
Mailing address
1697 HONORS CIR, CORONA, CA 92883-0757
(951) 582-9230
(951) 340-2740
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
336426012
CA
Other
Enumeration date
07/23/2014
Last updated
07/23/2014
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