| NPI | 1255549465 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDITH AVANZADO Licensee 626-793-9872 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities (Licence: CA 960000799) |
| Enumeration Date | 2007-05-19 |
| Last Update Date | 2008-08-13 |