Provider Demographics
NPI:1609624089
Name:EVERLASTING ASSISTED LIVING
Entity type:Organization
Organization Name:EVERLASTING ASSISTED LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CZARINA MAE
Authorized Official - Middle Name:
Authorized Official - Last Name:ARBOLEDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-245-5344
Mailing Address - Street 1:13527 JASPER LOOP
Mailing Address - Street 2:
Mailing Address - City:EASTVALE
Mailing Address - State:CA
Mailing Address - Zip Code:92880-8524
Mailing Address - Country:US
Mailing Address - Phone:213-245-5344
Mailing Address - Fax:
Practice Address - Street 1:29213 FERN PNE
Practice Address - Street 2:
Practice Address - City:LAKE ELSINORE
Practice Address - State:CA
Practice Address - Zip Code:92530-9143
Practice Address - Country:US
Practice Address - Phone:951-579-0794
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-09
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility