Organization
DALTON AVENUE HOMES, INC. - LOOP II
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TONY DOJCINOVIC (LICENSEE)
(310) 808-0883
Entity
Organization
Contact information
Practice address
15918 S DALTON AVE, GARDENA, CA 90247-3908
(310) 630-0636
(310) 808-0883
Mailing address
15920 S DALTON AVE, GARDENA, CA 90247-3908
(310) 808-0883
(310) 808-0883
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
CA
Other
Enumeration date
05/19/2007
Last updated
08/22/2020
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