Organization
WILSON HEALTHCARE, INC DBA HAWAIIAN HOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK F. WILSON (ADMINISTRATOR)
(562) 429-2616
Entity
Organization
Contact information
Practice address
12440 224TH ST, HAWAIIAN GARDENS, CA 90716-1718
(562) 429-2616
Mailing address
1027 CALLE JUCA DR, LA HABRA HEIGHTS, CA 90631-8654
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
CA
Other
Enumeration date
12/14/2006
Last updated
08/22/2020
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