Organization
GARDEN OF WILMINGTON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THELMA FLORES AD (BOARDING CARE ADMINISTOR)
(310) 835-6366
Entity
Organization
Contact information
Practice address
1311 W ANAHEIM ST, WILMINGTON, CA 90744-4109
(310) 835-6366
Mailing address
1311 W ANAHEIM ST, WILMINGTON, CA 90744-4109
(310) 835-6366
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
191601613
CA
Other
Enumeration date
05/12/2008
Last updated
05/12/2008
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