Organization · Type 2 NPI
Evelyn Lavern Thompson
Pediatric Skilled Nursing Facility · Moreno Valley, CA
NPI number
1104003763
Active
Practice location
12279 Lasselle St
Moreno Valley, CA 92557-7705
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Skilled Nursing Facility Primary | 3140N1450X | VN129832 (CA) |
Pediatric Skilled Nursing Facility: A nursing care facility designed and staffed for the provision of nursing care and appropriate educational and habilitative/rehabilitative services to children with multiple, complex or profound disabilities that can not be cared for in a less restrictive environment.
Another provider at this address
About NPI 1104003763
Evelyn Lavern Thompson's National Provider Identifier is 1104003763, issued on Jan 25, 2008. The primary taxonomy on file is Pediatric Skilled Nursing Facility (3140N1450X), and the practice location is in Moreno Valley, CA. The record was last updated on Jan 25, 2008.