Organization
SOUTHERN CALIFORNIA HEALTH CARES
Active
Other names
Life Sharing
Organization subpart
No
Provider details
NPI number
Authorized official
LESTER GERALD SPOELSTRA (OWNER - CEO)
(909) 747-5801
Entity
Organization
Contact information
Practice address
13909 1/2 AMAR RD, LA PUENTE, CA 91746-3601
(626) 814-3140
(626) 814-3294
Mailing address
415 TENNESSEE ST, SUITE U, REDLANDS, CA 92373-8168
(909) 747-5801
(909) 335-0494
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
060000614
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
112424664
MEDICAID
CA
Enumeration date
11/30/2016
Last updated
11/30/2016
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