Organization
RANCHO SAN ANTONIO BOYS HOME INC.
Active
Parent organization
RANCHO SAN ANTONIO BOYS HOME INC.
Other names
Rancho San Antonio
Organization subpart
Yes
Provider details
NPI number
Legal business name
RANCHO SAN ANTONIO BOYS HOME INC.
Authorized official
KELLEY BUTLER LCSW (MENTAL HEALTH DIRECTOR)
(818) 882-6400
Entity
Organization
Contact information
Practice address
21000 PLUMMER ST, CHATSWORTH, CA 91311-4903
(818) 882-6400
(818) 882-6404
Mailing address
21000 PLUMMER ST, CHATSWORTH, CA 91311-4903
(818) 882-6400
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02172
LOS ANGELES COUNTY DEPARTMENT OF MENTAL HEALTH
CA
Enumeration date
03/06/2019
Last updated
12/05/2024
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