Organization · Type 2 NPI
Model Residential Home, Inc.
Intellectual Disabilities Intermediate Care Facility · Los Angeles, CA
NPI number
1356619019
Active
Practice location
5129 Loleta Ave
Los Angeles, CA 90041-1501
Fax (323) 254-3655
Mailing address
1963 La Fremontia St
South Pasadena, CA 91030-4226
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Intellectual Disabilities Intermediate Care Facility Primary | 315P00000X | None listed |
Intellectual Disabilities Intermediate Care Facility: An intermediate care facility providing services for individuals with intellectual disabilities.
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About NPI 1356619019
Model Residential Home, Inc.'s National Provider Identifier is 1356619019, issued on Dec 9, 2011. The primary taxonomy on file is Intellectual Disabilities Intermediate Care Facility (315P00000X), and the practice location is in Los Angeles, CA. The record was last updated on Dec 9, 2011.