# LAXFORD HOUSE

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

## Provider details

- **NPI number:** 1760552111
- **Authorized official:** JULIET L HEBREO (ADMINISTRATOR)
- **Authorized official phone:** (626) 826-7870

## Contact information

- **Practice address:** 16814 E LAXFORD RD, AZUSA, CA 91702-5222
- **Practice address phone:** (626) 969-0800
- **Practice address fax:** (626) 969-0800
- **Mailing address:** 16814 E LAXFORD RD, AZUSA, CA 91702-5222
- **Mailing address phone:** (626) 969-0800
- **Mailing address fax:** (626) 969-0800

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | CA | Yes |

## Other

- **Enumeration date:** 11/09/2006
- **Last updated:** 08/22/2020