Organization
PALM HOUSE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RENATO DICCION CASACLANG (EXECUTIVE DIRECTOR)
(310) 830-7803
Entity
Organization
Contact information
Practice address
2515 E JEFFERSON ST, CARSON, CA 90810-1519
(310) 830-7803
(310) 830-6606
Mailing address
2515 E JEFFERSON ST, CARSON, CA 90810-1519
(310) 830-7803
(310) 830-6606
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
190040AN
CA
Other
Enumeration date
11/03/2015
Last updated
11/03/2015
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