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Organization
VILLA ESPERANZA SERVICES
Active
Organization
VILLA ESPERANZA SERVICES
Active
Other names
Stahl House
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY WHITE (CHIEF OPERATING OFFICER)
(626) 449-2919
Entity
Organization
Contact information
Practice address
443 N CRAIG AVE, PASADENA, CA 91107-2402
(626) 585-8528
Mailing address
2116 E VILLA ST, PASADENA, CA 91107-2435
(626) 449-2919
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
960000742
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LTC60466F
MEDICAL
CA
Enumeration date
05/14/2007
Last updated
02/20/2024
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