Organization
GREEN MERRYLANDS INC
Active
Other names
Green Merrylands Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
NA ZHAO (CFO)
(818) 267-0352
Entity
Organization
Contact information
Practice address
15986 BALTRAY WAY, FONTANA, CA 92336-4546
(909) 854-3227
Mailing address
800 N HAVEN AVE STE 210, ONTARIO, CA 91764-4951
(909) 476-0115
(909) 360-8757
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
—
—
320700000X
Physical Disabilities Residential Treatment Facility
—
—
Other
Enumeration date
07/29/2019
Last updated
07/29/2019
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