Shaded Arbor LLC
NPI #1003213950 in El Cajon, California
Provider Information
- NPI Number
- 1003213950
- Entity Type
- Organization
- Organization Name
- Shaded Arbor LLC
- Primary Specialty
- Assisted Living Facility
- Enumeration Date
- Nov 20, 2014
- Last Updated
- Nov 20, 2014
Practice Location
- Address
- 1412 GROVELAND TER
- City
- El Cajon
- State
- California
- ZIP Code
- 92021-3418
- Phone
- (619) 631-7000
Authorized Official
- Name
- RICHARD MUTKA
- Title
- OWNER
- Phone
- (951) 961-7410
Specialties & Taxonomy Codes
| Specialty |
|---|
| Assisted Living Facility |
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