| NPI | 1043956394 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SOPHESIAS JOHNSON Administrator/Ow Er 310-749-5563 |
| Organization Subpart ? | No |
| Primary Taxonomy | 385H00000X Respite Care |
| Additional Taxonomies | 174200000X Meals |
| 251T00000X PACE Provider Organization | |
| 310400000X Assisted Living Facility | |
| 251G00000X Hospice Care, Community Based | |
| 310500000X Intermediate Care Facility, Mental Illness | |
| 177F00000X Lodging | |
| 311Z00000X Custodial Care Facility | |
| 311ZA0620X Custodial Care Facility, Adult Care Home | |
| 347C00000X Private Vehicle | |
| 251J00000X Nursing Care | |
| 320700000X Residential Treatment Facility, Physical Disabilities | |
| Enumeration Date | 2022-05-10 |
| Last Update Date | 2025-12-24 |