Organization
PAX HOUSE INC.
Active
Parent organization
PAX HOUSE INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
PAX HOUSE INC.
Authorized official
MR. JORDAN TAYLOR DESIMONE CADC-CAS (PROGRAM DIRECTOR)
(626) 808-0335
Entity
Organization
Contact information
Practice address
2052 LAKE AVE STE F, ALTADENA, CA 91001
(626) 808-0335
(626) 270-4640
Mailing address
1717 E MENDOCINO STREET, ALTADENA, CA 91001
(626) 398-3897
(626) 270-4640
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
190732BP
CA
Other
Enumeration date
04/26/2018
Last updated
06/01/2018
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