Organization
PATE & INGAM HOME 2
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WESLEY PATE (LICENSEE)
(310) 330-0097
Entity
Organization
Contact information
Practice address
2303 W 116TH ST, HAWTHORNE, CA 90250-1970
(323) 756-9567
(323) 756-1788
Mailing address
17433 BAUCHARD CT, CARSON, CA 90746-1609
(310) 330-0097
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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