Organization
CHANCELLOR HEALTH CARE OF CA
Active
Other names
linda valley care center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID LUTHER GREEN NHA (ADMINISTRATOR)
(909) 796-0235
Entity
Organization
Contact information
Practice address
25383 COLE ST, LOMA LINDA, CA 92354-3103
(909) 796-0235
(909) 796-6366
Mailing address
25383 COLE ST, LOMA LINDA, CA 92354-3103
(909) 796-0235
(909) 796-6366
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
22T05299H
—
CA
Enumeration date
09/14/2005
Last updated
08/22/2020
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