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Organization

EON RESOURCES CORP

Active
Other names
LA VERNE MANOR
Organization subpart
No

Provider details

NPI number
Authorized official
JOHN MICHAEL TANADA (ADMINISTRATOR)
(909) 593-4567
Entity
Organization

Contact information

Practice address
2555 6TH ST, LA VERNE, CA 91750-4617
(909) 593-4567
(909) 971-3108
Mailing address
PO BOX 987, LA VERNE, CA 91750-0987
(909) 593-4567
(909) 971-3108

Taxonomy

Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary

Other

Enumeration date
07/22/2021
Last updated
07/22/2021
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