Organization
STAR ICF/DD-N WAKEFIELD HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LIZA DARADAR DE LOS ANGELES RN (OWNER/ADMINISTRATOR)
(562) 400-1503
Entity
Organization
Contact information
Practice address
14621 WAKEFIELD ST, WESTMINSTER, CA 92683-5718
(562) 400-1503
(174) 183-9863
Mailing address
14621 WAKEFIELD ST, WESTMINSTER, CA 92683-5718
(562) 400-1503
(174) 183-9863
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
550000699
CA
Other
Enumeration date
05/22/2008
Last updated
05/22/2008
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