Organization
DOMART BOARD AND CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMMA TERESITA LU (LICENSEE/ OWNER)
(562) 229-2781
Entity
Organization
Contact information
Practice address
13817 DOMART AVE, NORWALK, CA 90650-3428
(562) 484-9134
(562) 484-9134
Mailing address
13817 DOMART AVE, NORWALK, CA 90650-3428
(562) 484-9134
(562) 484-9134
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
198601875
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
198601875
DEPT. OF SOCIAL SERVICES - CCLD
CA
Enumeration date
03/30/2016
Last updated
03/30/2016
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