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General NPI Number Information
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NPI Number | 1316317480
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Entity Type | Organization
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Legal Business Name | PARKSIDE MANSION ASSISTED LIVING
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Dates
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Enumeration Date | 10/02/2015
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Last Update Date | 10/02/2015
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Provider Practice Location Address
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Address Line | 2789 RAFFERTY RD
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City | HEMET
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State | CA
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Zip | 92545-3630
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Country | US
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Telephone | 951-929-8880
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Fax | 951-392-2247
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Provider Business Mailing Address
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Address Line | 2789 RAFFERTY RD
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City | HEMET
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State | CA
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Zip | 92545-3630
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Country | US
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Telephone | 951-929-8880
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Fax | 951-392-2247
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Authorized Official
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Title or Position | OWNER
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Name | JULIE ABLANIDA
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Credential |
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Telephone | 951-473-0590
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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 | 336426284
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License Number State | CA
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