NPI 1013125228

126th Street Homes, INC. - Loop Home I

Organisation Intellectual Disabilities Intermediate Care Facility Hawthorne, CA

Practice location

Address: 4180 W 126th St, Hawthorne, CA 90250-4547
Phone: (310) 676-7634
Fax: (310) 808-0883
Mailing address: 15920 S Dalton Ave, Gardena, CA 90247-3908

Authorised official

Name: Tony Dojcinovic
Title: Licensee
Phone: (310) 808-0883

Registered specialties

Intellectual Disabilities Intermediate Care Facility Primary

Nursing & Custodial Care Facilities Taxonomy 315P00000X

Other Intermediate Care Facility, Intellectual Disabilities providers in California →

Registry record

NPI: 1013125228
Entity type: Organization
NPI issued: 19 May 2007
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.