Organization
EAST LA REMARKABLE CITIZENS ASSN
Active
Other names
Casa Rosa ICF DDS
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CARLOS E MADRID MSW MPA (CEO PRESIDENT ADMINISTRATOR)
(323) 223-3079
Entity
Organization
Contact information
Practice address
8242 WESTMAN AVE, WHITTIER, CA 90606-3315
(562) 699-0472
(562) 699-0472
Mailing address
3839 SELIG PLACE, LOS ANGELES, CA 90031-3143
(323) 223-3079
(323) 223-4684
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LTC60432F
MEDICAL
CA
Enumeration date
02/20/2007
Last updated
08/22/2020
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