| NPI | 1356619019 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVELYN MORENO Owner/Licensee 323-254-3621 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Mentally Retarded |
| Enumeration Date | 2011-12-09 |
| Last Update Date | 2011-12-09 |