Organization
COVENANT LIVING WEST
Active
Other names
Mount Miguel Covenant Village Health Facility
Organization subpart
No
Provider details
NPI number
Authorized official
B.J. FERRIS (MANAGER)
(619) 479-4790
Entity
Organization
Contact information
Practice address
325 KEMPTON ST, SPRING VALLEY, CA 91977-5810
(619) 931-1114
Mailing address
325 KEMPTON ST, SPRING VALLEY, CA 91977-5810
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
090000080
CA
Other
Enumeration date
12/29/2006
Last updated
07/30/2019
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