NPI | 1073721288 |
---|---|
Doing Business As | LAVERNA GUEST HOME |
Entity Type | Organization |
Authorized Contact | EVELYN MORENO Licensee 323-254-3621 |
Organization Subpart ? | No |
Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities (Licence: CA 960001042) |
Enumeration Date | 2007-05-19 |
Last Update Date | 2008-06-19 |