Healthcare Provider Details

I. General information

NPI: 1548562150
Provider Name (Legal Business Name): LITTLE HOUSE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2010
Last Update Date: 07/27/2023
Certification Date: 07/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9718 HARVARD ST
BELLFLOWER CA
90706-3635
US

IV. Provider business mailing address

9718 HARVARD ST
BELLFLOWER CA
90706-3635
US

V. Phone/Fax

Practice location:
  • Phone: 562-925-2777
  • Fax: 562-925-7572
Mailing address:
  • Phone: 562-925-2777
  • Fax: 562-925-7572

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number190029AN
License Number StateCA

VIII. Authorized Official

Name: SAMANTHA SALMERON
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 562-533-4532