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Organization
OUR LADY OF MERCY HOME 2
Active
Organization
OUR LADY OF MERCY HOME 2
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LYDIA S DEBASTIAN RN (OWNER/LICENCEE)
(909) 578-5453
Entity
Organization
Contact information
Practice address
3845 S MORGANFIELD AVE, WEST COVINA, CA 91792-3238
(909) 444-5796
(909) 594-3604
Mailing address
3845 S MORGANFIELD AVE, WEST COVINA, CA 91792-3238
(909) 444-5796
(909) 594-3604
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
CA
Other
Enumeration date
03/12/2012
Last updated
03/12/2012
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