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Organization
GOLDEN STATE RECUPERATIVE CARE, INC.
Active
Organization
GOLDEN STATE RECUPERATIVE CARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL GONZALEZ (DIRECTOR OF OPERATIONS)
(323) 475-1127
Entity
Organization
Contact information
Practice address
153 E. 110TH ST, LOS ANGELES, CA 90061
(323) 475-1126
(323) 475-1132
Mailing address
153 E. 110TH ST, LOS ANGELES, CA 90061
(323) 475-1126
(323) 475-1132
Taxonomy
Speciality
Code
Description
License number
State
177F00000X
Lodging Provider
—
NULL
251X00000X
Supports Brokerage Agency
—
NULL
385H00000X
Respite Care
Primary
—
NULL
Other
Enumeration date
02/05/2020
Last updated
02/09/2022
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