# OUR LADY OF MERCY HOME

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154590495
- **Authorized official:** LYDIA SEBASTIAN (ADMINISTRATOR)
- **Authorized official phone:** (909) 444-5796

## Contact information

- **Practice address:** 3409 E HILLTONIA DR, WEST COVINA, CA 91792-2934
- **Practice address phone:** (909) 444-5796
- **Mailing address:** PO BOX 1862, WALNUT, CA 91788-1862
- **Mailing address phone:** (909) 444-5796
- **Mailing address fax:** (909) 444-5796

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | CA | Yes |

## Other

- **Enumeration date:** 02/20/2008
- **Last updated:** 02/20/2008