Organization
IVAN BANNER BOARDING CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CYNTHIA TAYLOR (LICENSEE)
(661) 267-0779
Entity
Organization
Contact information
Practice address
39409 DAYLILY PL, PALMDALE, CA 93551-4161
(661) 267-0779
Mailing address
39409 DAYLILY PL, PALMDALE, CA 93551-4161
(661) 267-0779
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
10/05/2022
Last updated
10/05/2022
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