| NPI | 1083586143 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHEILA PATRICE BAGSBY Licensee/Administrator 310-925-8857 |
| Organization Subpart ? | No |
| Primary Taxonomy | 385H00000X Respite Care |
| Additional Taxonomies | 174200000X Meals |
| 177F00000X Lodging | |
| 310400000X Assisted Living Facility | |
| 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness | |
| 3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 311500000X Alzheimer Center (Dementia Center) | |
| 311ZA0620X Custodial Care Facility, Adult Care Home | |
| Enumeration Date | 2025-09-19 |
| Last Update Date | 2025-09-19 |