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Organization
LAVENDER RISE HOMES LLC
Active
Organization
LAVENDER RISE HOMES LLC
Active
Other names
Lavender Rise Homes LLC
Organization subpart
No
Provider details
NPI number
Authorized official
OCTAVIA BROWN (CEO)
(310) 968-5849
Entity
Organization
Contact information
Practice address
10713 MOUNTAIN VIEW AVE, LOMA LINDA, CA 92354-2519
(310) 968-5849
Mailing address
PO BOX 1361, LITTLEROCK, CA 93543-5361
(310) 968-5849
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Enumeration date
01/14/2022
Last updated
01/14/2022
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