Organization
GOLDEN STATE RECUPERATIVE CARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL GONZALEZ (DIRECTOR OF OPERATIONS)
(323) 475-1127
Entity
Organization
Contact information
Practice address
153 E. 110TH ST, LOS ANGELES, CA 90061
(323) 475-1126
(323) 475-1132
Mailing address
153 E. 110TH ST, LOS ANGELES, CA 90061
(323) 475-1126
(323) 475-1132
Taxonomy
Speciality
Code
Description
License number
State
177F00000X
Lodging Provider
—
—
251X00000X
Supports Brokerage Agency
—
—
385H00000X
Respite Care
Primary
—
—
Other
Enumeration date
02/05/2020
Last updated
02/09/2022
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