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Organization

DR. MARY E. WALKER CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LADESCA DAWN SMITH LPN (LPN)
(760) 386-3290
Entity
Organization

Contact information

Practice address
5306A GOPHER LN, FORT IRWIN, CA 92310-2205
(760) 386-3290
Mailing address
5306A GOPHER LN, FORT IRWIN, CA 92310-2205
(760) 386-3290

Taxonomy

Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
218428
CA

Other

Enumeration date
11/06/2006
Last updated
08/22/2020
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