NPI 1164663746

Pacific Home Ca

Organisation Intellectual and/or Developmental Disabilities Residential Treatment Facility Carson, CA

Practice location

Address: 254 E 220th St, Carson, CA 90745-3012
Phone: (310) 518-5178
Fax: (310) 518-5005

Authorised official

Name: Rosaline B Tanglao
Title: Owner/Licensee
Phone: (310) 518-5178

Registered specialties

Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320600000X

Other Residential Treatment Facility, Intellectual and/or Developmental Disabilities providers in California →

Registry record

NPI: 1164663746
Entity type: Organization
NPI issued: 12 Mar 2009
Record last updated: 12 Mar 2009

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.