Organization
CREATIVE LIFESTYLES HOME CARE INC
Active
Other names
Montiano Residential Care
Organization subpart
No
Provider details
NPI number
Authorized official
CLAREL MARTINE (CEO)
(323) 758-9539
Entity
Organization
Contact information
Practice address
1022 W FLORENCE AVE, LOS ANGELES, CA 90044-2442
(323) 758-9539
Mailing address
1022 W FLORENCE AVE, LOS ANGELES, CA 90044-2442
(323) 758-9539
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
Other
Enumeration date
05/28/2019
Last updated
06/26/2021
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