Organization
ELEGANT LEGACY HOME CARE AND REHAB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA LONTAYO OT (OWNER/CEO)
(858) 880-8934
Entity
Organization
Contact information
Practice address
12180 RAGWEED ST, SAN DIEGO, CA 92129-4104
(858) 880-8934
Mailing address
12180 RAGWEED ST, SAN DIEGO, CA 92129-4104
(858) 880-8934
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
03/02/2020
Last updated
03/02/2020
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