Organization
CITRUS CREST CARE HOME 2 LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MUAMOUDOU AIDARA SOUMAHORO (CEO)
(510) 509-7098
Entity
Organization
Contact information
Practice address
6813 MARINVALE DR, CITRUS HEIGHTS, CA 95621-1937
(510) 409-7098
Mailing address
6813 MARINVALE DR, CITRUS HEIGHTS, CA 95621-1937
(510) 409-7098
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
08/29/2022
Last updated
08/29/2022
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