Organization
GM HOME, INC. - II
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN MARTINEZ (LICENSEE)
(562) 631-4157
Entity
Organization
Contact information
Practice address
14771 RAGAN DR, LA MIRADA, CA 90638-2204
(562) 946-9266
(562) 352-0046
Mailing address
15406 OLIVE BRANCH DR, LA MIRADA, CA 90638-2430
(562) 631-4157
(562) 352-0046
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
CA
Other
Enumeration date
05/19/2007
Last updated
08/22/2020
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