Organization
ALTA VISTA CONGREGATE LIVING, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE STINSON (VICE PRESIDENT)
(626) 373-7619
Entity
Organization
Contact information
Practice address
13880 PROCTOR AVE, LA PUENTE, CA 91746-2529
(626) 373-7619
(888) 385-1958
Mailing address
13880 PROCTOR AVE, LA PUENTE, CA 91746-2529
(626) 373-7619
(888) 385-1958
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
06/16/2021
Last updated
07/09/2021
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