Organization
GRANDMOTHERS VILLAGE APC
Active
Other names
Kensington Nurses Registry
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL SANDERSON II (ADMINISTRATOR)
(619) 466-8773
Entity
Organization
Contact information
Practice address
8469 LA MESA BLVD, LA MESA, CA 91942-5335
(619) 466-8773
Mailing address
8469 LA MESA BLVD, LA MESA, CA 91942-5335
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
—
—
Other
Enumeration date
07/27/2018
Last updated
07/27/2018
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