| NPI | 1679788566 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEAN TIMBOL Licensee 323-478-1936 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities (Licence: CA 960001059) |
| Enumeration Date | 2007-05-13 |
| Last Update Date | 2020-08-22 |