NPI 1003213950

Shaded Arbor LLC

Organisation Assisted Living Facility El Cajon, CA

Practice location

Address: 1412 Groveland Ter, El Cajon, CA 92021-3418
Phone: (619) 631-7000
Fax: (619) 631-7591

Authorised official

Name: Richard Mutka
Title: Owner
Phone: (951) 961-7410

Registered specialties

Assisted Living Facility Primary

Nursing & Custodial Care Facilities Taxonomy 310400000X Licence 374603523 (CA)

Other Assisted Living Facility providers in California →

Registry record

NPI: 1003213950
Entity type: Organization
NPI issued: 20 Nov 2014
Record last updated: 20 Nov 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.