Organization
LAVENDER RISE HOMES LLC
Active
Other names
Lavender Rise Homes LLC
Organization subpart
No
Provider details
NPI number
Authorized official
OCTAVIA BROWN (CEO)
(310) 968-5849
Entity
Organization
Contact information
Practice address
10713 MOUNTAIN VIEW AVE, LOMA LINDA, CA 92354-2519
(310) 968-5849
Mailing address
PO BOX 1361, LITTLEROCK, CA 93543-5361
(310) 968-5849
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Enumeration date
01/14/2022
Last updated
01/14/2022
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