Individual
CAYLA TILLMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1431 W 97TH ST, LOS ANGELES, CA 90047-3934
(323) 303-9808
Mailing address
1431 W 97TH ST, LOS ANGELES, CA 90047-3934
(323) 303-9808
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
198320238
CA
Other
Enumeration date
05/17/2016
Last updated
12/29/2023
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