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Evelyn Lavern Thompson
Pediatric Skilled Nursing Facility in Moreno Valley, California
NPI 1104003763

Evelyn Lavern Thompson is a Pediatric Skilled Nursing Facility based in Moreno Valley, CA and is specialized in Nursing Care, Pediatric. Evelyn Lavern Thompson practices in Moreno Valley, CA. The NPI Number for Evelyn Lavern Thompson is 1104003763 and holds a License No. VN129832 (California).

The current practice location address for Evelyn Lavern Thompson is 12279 Lasselle St, Moreno Valley, CA and can be reached out via phone at 951-485-6847.

Location: 12279 Lasselle St, Moreno Valley, CA, 92557-7705
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1104003763
Provider Name
Evelyn Lavern Thompson
Credential
Provider Entity Type
Organization
Address
12279 Lasselle St, Moreno Valley, CA, 92557-7705
Phone Number
951-485-6847
Fax Number
Provider Enumeration Date
01/25/2008
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
12279 Lasselle St
City
Moreno Valley
State
California
Zip
92557-7705
Phone Number
951-485-6847
Fax Number
person
Provider Business Mailing Address Details
Address
12279 Lasselle St
City
Moreno Valley
State
California
Zip
92557-7705
Phone Number
951-485-6847
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Skilled Nursing Facility
Speciality
Nursing Care, Pediatric
Taxonomy
3140N1450X
License No.
VN129832 (California)
Definition
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.
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