Organization
WOODLAWN PARK, INC
Active
Other names
Woodlawn Park
Organization subpart
No
Provider details
NPI number
Authorized official
KATHERINE LANCE (OWNER)
(310) 638-6691
Entity
Organization
Contact information
Practice address
3898 WOODLAWN AVE, LYNWOOD, CA 90262-3729
(310) 638-6691
Mailing address
3351 E IMPERIAL HWY, LYNWOOD, CA 90262-3305
(310) 638-6691
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
960001449
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
550001854
—
CA
05
—
LTC61047F
—
CA
Enumeration date
02/06/2007
Last updated
05/07/2012
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