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

## Provider details

- **NPI number:** 1316794233
- **Authorized official:** MR. ALBERT HERRERA (CHIEF DEVELOPMENT OFFICE)
- **Authorized official phone:** (626) 660-8924

## Contact information

- **Practice address:** 1027 S CENTRAL AVE, GLENDALE, CA 91204-3957
- **Practice address phone:** (818) 296-4644
- **Mailing address:** 1027 S CENTRAL AVE, GLENDALE, CA 91204-3957
- **Mailing address phone:** (818) 296-4644

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |
| 385H00000X | Respite Care | — | NULL | — |

## Other

- **Enumeration date:** 04/30/2024
- **Last updated:** 04/30/2024
