126th Street Homes, Inc. - Loop Home I

NPI 1013125228 - Intermediate Care Facility, Mentally Retarded - 315P00000X

NPI Details
NPI 1013125228
Enumeration Date 05/19/2007
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 11 years ago
Authorized Information
Name TONY TONY
Position LICENSEE
Phone (310) 676-7634
Fax (310) 808-0883
Practice Location
4180 W 126TH ST
HAWTHORNE CA, 90250-4547, US
Phone (310) 676-7634
Fax (310) 808-0883
Business Location
15920 S DALTON AVE
GARDENA CA, 90247-3908, US
Phone (310) 808-0883
Fax (310) 808-0883
Toxanomy
Taxonomy Code 315P00000X
License State
License Number
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According to our database, 126th Street Homes, Inc. - Loop Home I NPI is 1013125228, taxonomy code is 315P00000X 126th Street Homes, Inc. - Loop Home I physically located at 4180 W 126th St, Hawthorne CA, 90250-4547. NPI Number 1033115704 has the healthcare provider type.

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1013125228 NPI number is provided on an as is basis without warranty of any kind. 1013125228 is maintained by the National Plan & Provider Enumeration System. The contents of 126th Street Homes, Inc. - Loop Home I are for informational purposes only.