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Organization

THE COMPASSIONATE SAMARITAN, INC

Active
Other names
Ardilla Residential Care
Organization subpart
No

Provider details

NPI number
Authorized official
MR. THOMAS ALLEN HOWARD (CHIEF EXECUTIVE OFFICER)
(626) 939-4433
Entity
Organization

Contact information

Practice address
3662 ARDILLA AVE, BALDWIN PARK, CA 91706-5635
(626) 939-4433
(626) 698-4801
Mailing address
3662 ARDILLA AVE, BALDWIN PARK, CA 91706-5635
(626) 939-4433
(626) 698-4801

Taxonomy

Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
360911118
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
360911118
MEDI-CAL
CA
Enumeration date
08/27/2009
Last updated
08/27/2009
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