Organization
CROFT LIVING HOME, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHADY BORNA P.A (PRESIDENT)
(323) 655-5060
Entity
Organization
Contact information
Practice address
458 N CROFT AVE, LOS ANGELES, CA 90048-2509
(323) 655-5060
(323) 651-1461
Mailing address
458 N CROFT AVE, LOS ANGELES, CA 90048-2509
(323) 655-5060
(323) 651-1461
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
550002351
CA
Other
Enumeration date
08/15/2013
Last updated
08/15/2013
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