Organization
INDEPENDENT LIVING CENTER OF SOUTHERN CALIFORNIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NORMA JEAN VESCOVO (EXECUTIVE DIRECTOR)
(818) 785-6934
Entity
Organization
Contact information
Practice address
14407 GILMORE ST, #101, VAN NUYS, CA 91401-1400
(818) 785-6934
(818) 785-0330
Mailing address
14407 GILMORE ST, #101, VAN NUYS, CA 91401-1400
(818) 785-6934
(818) 785-0330
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
10/18/2010
Last updated
10/18/2010
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