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Organization

BURNETTS ICF DD H

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BONNIE ADAMS RN MSN EDD (RN ADMINISTRATOR)
(562) 941-1384
Entity
Organization

Contact information

Practice address
9045 CARRON DR, PICO RIVERA, CA 90660
(562) 942-7343
(562) 696-2191
Mailing address
9045 CARRON DR, PICO RIVERA, CA 90660
(562) 942-7343
(562) 696-2191

Taxonomy

Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
05G234
MEDICAL PROVIDER #
CA
Enumeration date
03/30/2007
Last updated
08/22/2020
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