Organization
FERN HOME 1 LLC
Active
Other names
FERN HOME 1
Organization subpart
No
Provider details
NPI number
Authorized official
JOI MAE GUBALANE RCFE ADMINISTRATOR (LICENSEE/ADMINISTRATOR)
(310) 997-8204
Entity
Organization
Contact information
Practice address
3875 MEGGINSON LN, RIVERSIDE, CA 92503-3425
(310) 997-8204
Mailing address
3875 MEGGINSON LANE, RIVERSIDE, CA 92503
(310) 997-8204
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
331800142
CA
Other
Enumeration date
08/16/2017
Last updated
07/21/2022
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