NPI | 1346458569 |
---|---|
Doing Business As | BERRYMAN AVENUE HOUSE |
Entity Type | Organization |
Authorized Contact | FAYE WILLIAMS Licensee 310-674-8345 |
Organization Subpart ? | No |
Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities (Licence: CA 960000533) |
Enumeration Date | 2007-05-19 |
Last Update Date | 2008-06-20 |