Organization
MONTE VISTA GROVE HOMES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIM PATRICE HOUSER (CFO)
(626) 389-6436
Entity
Organization
Contact information
Practice address
2889 SAN PASQUAL ST, PASADENA, CA 91107-5364
(626) 796-6135
Mailing address
2889 SAN PASQUAL ST, PASADENA, CA 91107-5364
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
07/30/2019
Last updated
07/30/2019
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