Organization
TNA
Active
Organization
TNA
Active
Other names
Casa Viejos Asssited Living
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER THOMPSON RN (ADMIN)
(209) 984-5124
Entity
Organization
Contact information
Practice address
18760 CHABROULLIAN LN, JAMESTOWN, CA 95327-9617
(209) 984-5124
Mailing address
18760 CHABROULLIAN LN, JAMESTOWN, CA 95327-9617
(209) 984-5124
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
557003146
CA
Other
Enumeration date
05/19/2014
Last updated
05/19/2014
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