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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MARK JORDAN AGRESOR

Active Sole Proprietor

MARK JORDAN AGRESOR is a Assisted Living Facility healthcare provider located in PALM SPRINGS, California. NPI 1265971162 is currently active in the NPPES registry. Verify at CMS.

Assisted Living Facility · PALM SPRINGS, CA

Registration Details

NPI Number
1265971162
Provider Type
Individual
Gender
Male
NPI Issued
Feb 13, 2017 (9.5165308681507 yrs)
Last Updated
Feb 13, 2017
License
00859592 (CA)
Sole Proprietor
Yes

Practice Information

Address
4425 CAMINO PAROCELA
PALM SPRINGS, CA, 92264
Browse CA providers · Browse ZIP 92264
Phone
7604132998
Primary Specialty
Assisted Living Facility
310400000X

Other Assisted Living Facility Providers in PALM SPRINGS, CA

Name Credential NPI
WILLIE JUNIOR MOYER III 1730531096
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.