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General NPI Number Information
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NPI Number | 1124585658
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Entity Type | Organization
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Legal Business Name | GABRIELA CARE HOME, INC.
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Dates
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Enumeration Date | 02/20/2019
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Last Update Date | 03/01/2022
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Provider Practice Location Address
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Address Line | 1717 TAMARRON DR
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City | CORONA
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State | CA
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Zip | 92883-0765
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Country | US
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Telephone | 951-427-3631
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Fax | 951-547-1369
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Provider Business Mailing Address
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Address Line | 1717 TAMARRON DR
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City | CORONA
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State | CA
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Zip | 92883-0765
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Country | US
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Telephone | 951-427-3631
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. RESTITUTO LUMBA CALILUNG
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Credential |
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Telephone | 714-906-6046
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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