Organization
GRANDVIEW FOUNDATION, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LINDY RAE CARLL B.A. J.D. (EXECUTIVE DIRECTOR)
(626) 797-1124
Entity
Organization
Contact information
Practice address
225 GRANDVIEW STREET, PASADENA, CA 91104
(626) 797-1124
(626) 398-5984
Mailing address
1230 NORTH MARENGO AVENUE, PASADENA, CA 91103-2217
(626) 797-1124
(626) 398-9674
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
190022AN
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6736
DRUG MEDI-CAL
CA
Enumeration date
10/14/2016
Last updated
03/27/2018
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