| NPI | 1437367653 |
|---|---|
| Doing Business As | BEACH 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 960000566) |
| Enumeration Date | 2007-05-19 |
| Last Update Date | 2008-06-20 |