Organization
MONDELL PINE MANOR II
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEROME DELA CRUZ VIRAY (ADMINISTRATOR)
(818) 332-6150
Entity
Organization
Contact information
Practice address
39040 MONDELL PINE AVE, PALMDALE, CA 93551-6042
(818) 332-6150
(805) 578-4986
Mailing address
1716 ERRINGER RD STE 104, SIMI VALLEY, CA 93065-6506
(818) 332-6150
(805) 578-4986
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
08/29/2023
Last updated
07/31/2024
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