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Organization
LUIS G CENDANA
Active
Organization
LUIS G CENDANA
Active
Other names
K AND S GROUP HOME 1
Organization subpart
No
Provider details
NPI number
Authorized official
DIVINA PASAPORTE CENDANA (OWNER)
(310) 634-9251
Entity
Organization
Contact information
Practice address
1503 254TH ST, HARBOR CITY, CA 90710-2716
(310) 326-0374
(310) 517-4843
Mailing address
1503 254TH ST, HARBOR CITY, CA 90710-2716
(310) 326-0374
(310) 517-4843
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
320600000X
—
CA
Enumeration date
10/09/2006
Last updated
07/02/2008
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