Organization
KOLES PLACE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NEEKOLE GLASPIE (ADMINISTRATOR)
(310) 462-2730
Entity
Organization
Contact information
Practice address
8630 RAYFORD DR, LOS ANGELES, CA 90045-3512
(310) 670-6965
(424) 227-6024
Mailing address
8630 RAYFORD DR, LOS ANGELES, CA 90045-3512
(310) 670-6965
(424) 227-6024
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LTC 60731F
—
CA
Enumeration date
06/16/2015
Last updated
06/16/2015
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