Extraordinary Living Gp
NPI #1073312005 in Perris, California
Provider Information
- NPI Number
- 1073312005
- Entity Type
- Organization
- Organization Name
- Extraordinary Living Gp
- Primary Specialty
- Custodial Care Facility - Adult Care Home
- Enumeration Date
- Mar 11, 2025
- Last Updated
- Mar 11, 2025
Practice Location
- Address
- 4372 ALMATERRA DR
- City
- Perris
- State
- California
- ZIP Code
- 92571-5112
- Phone
- (562) 897-6041
Authorized Official
- Name
- JACQUIECE PARKER
- Title
- ADMINISTRATOR
- Phone
- (562) 897-6041
Specialties & Taxonomy Codes
| Specialty |
|---|
| Custodial Care Facility - Adult Care Home — Adult Care Home |
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