Organization
LA CASA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIET DANIELS (LICENSEE)
(310) 266-7380
Entity
Organization
Contact information
Practice address
15333 DAPHNE AVE, GARDENA, CA 90249-4123
(310) 327-7798
(310) 327-7715
Mailing address
PO BOX 513745, LOS ANGELES, CA 90051-1745
(310) 266-7380
(310) 327-7715
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
960001099
CA
Other
Enumeration date
05/19/2007
Last updated
06/17/2008
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