| NPI | 1063896462 |
|---|---|
| Doing Business As | ST THERESE HOME |
| Entity Type | Organization |
| Authorized Contact | VEN AUGUSTUS VELASCO Owner 818-212-9159 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| Enumeration Date | 2015-07-15 |
| Last Update Date | 2015-07-15 |