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Organization

VILLA ESPERANZA SERVICES

Active
Other names
Stahl House
Organization subpart
No

Provider details

NPI number
Authorized official
KELLY WHITE (CHIEF OPERATING OFFICER)
(626) 449-2919
Entity
Organization

Contact information

Practice address
443 N CRAIG AVE, PASADENA, CA 91107-2402
(626) 585-8528
Mailing address
2116 E VILLA ST, PASADENA, CA 91107-2435
(626) 449-2919

Taxonomy

Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
960000742
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
LTC60466F
MEDICAL
CA
Enumeration date
05/14/2007
Last updated
02/20/2024
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