NPI 1821872797

Ironwood Lake House

Organisation Psychiatric Residential Treatment Facility South China, ME

Practice location

Address: 24 Pond Hill Rd, South China, ME 04358-5009
Phone: (310) 457-6302
Fax: (310) 457-6318
Mailing address: 12424 Wilshire Blvd STE 800, Los Angeles, CA 90025-1035

Authorised official

Name: Debora Garcia
Title: Rcm Manager
Phone: (310) 457-6302

Registered specialties

Psychiatric Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 323P00000X

Other Psychiatric Residential Treatment Facility providers in Maine →

Registry record

NPI: 1821872797
Entity type: Organization
NPI issued: 22 Aug 2023
Record last updated: 22 Aug 2023

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.