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Organization
LEADWELL CARE HOME, INC.
Active
Organization
LEADWELL CARE HOME, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LOVELY DADIVAS ONG RN (LICENSEE)
(818) 625-8874
Entity
Organization
Contact information
Practice address
17256 LEADWELL ST, VAN NUYS, CA 91406-2537
(818) 625-8874
Mailing address
17256 LEADWELL ST, VAN NUYS, CA 91406-2537
(818) 625-8874
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
550002447
CA
Other
Enumeration date
11/07/2014
Last updated
11/07/2014
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