Organization
OUR HOUSE THEATRICAL LIVING & LEARNING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BARBARA W. SHALWAN (PRESIDENT-C.E.O.- DIRECTOR)
(310) 763-4998
Entity
Organization
Contact information
Practice address
1132 E. DOMINGUEZ ST., SUITE B & C, CARSON, CA 90746
(310) 763-4998
(310) 886-3064
Mailing address
1132 E. DOMINGUEZ ST., SUITE B & C, CARSON, CA 90746
(310) 763-4998
(310) 886-3064
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
BUS.PERMIT NO.62287A
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
198600661
FACILITY #
CA
Enumeration date
12/09/2008
Last updated
12/09/2008
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