Organization
SPRING LIVING INC
Active
Other names
Dore Home
Organization subpart
No
Provider details
NPI number
Authorized official
HARVIENIA WILLIAMS (CEO)
(626) 913-0751
Entity
Organization
Contact information
Practice address
1118 E DORE ST, WEST COVINA, CA 91792-1341
(626) 913-0751
Mailing address
18800 AMAR RD, C-12, WALNUT, CA 91789-4166
(626) 913-0751
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LTC61003F
PROVIDER NUMBER
CA
Enumeration date
04/10/2007
Last updated
11/06/2007
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