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Organization
IRONWOOD LAKE HOUSE
Active
Organization
IRONWOOD LAKE HOUSE
Active
Parent organization
IRONWOOD MAINE
Other names
Ironwood lake House
Organization subpart
Yes
Provider details
NPI number
Legal business name
IRONWOOD MAINE
Authorized official
DEBORA GARCIA (RCM MANAGER)
(310) 457-6302
Entity
Organization
Contact information
Practice address
24 POND HILL RD, SOUTH CHINA, ME 04358-5009
(310) 457-6302
(310) 457-6318
Mailing address
12424 WILSHIRE BLVD STE 800, LOS ANGELES, CA 90025-1035
(310) 457-6302
(310) 457-6318
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
—
NULL
Other
Enumeration date
08/22/2023
Last updated
08/22/2023
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