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Organization
EAST LOS ANGELES REMARKABLE CITIZEN ASSN
Active
Organization
EAST LOS ANGELES REMARKABLE CITIZEN ASSN
Active
Other names
Casa Terry
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CARLOS E MADRID MSW MPA (CEO PRESIDENT ADMINISTRATOR)
(323) 223-3079
Entity
Organization
Contact information
Practice address
15576 LUJON ST, HACIENDA HEIGHTS, CA 91745
(626) 333-7554
Mailing address
3839 SELIG PLACE, LOS ANGELES, CA 90031
(323) 223-3079
(323) 223-4684
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LTC60893F
MEDICAL
CA
Enumeration date
02/20/2007
Last updated
08/22/2020
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