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General NPI Number Information
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NPI Number | 1164669446
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Entity Type | Organization
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Legal Business Name | LARK SPRING TERRACE INCORPORATED
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Dates
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Enumeration Date | 01/08/2009
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Last Update Date | 04/17/2024
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Provider Practice Location Address
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Address Line | 22504 LARK SPRING TER
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City | DIAMOND BAR
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State | CA
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Zip | 91765-2956
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Country | US
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Telephone | 909-860-2622
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Fax | 909-860-2622
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Provider Business Mailing Address
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Address Line | 22504 LARK SPRING TER
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City | DIAMOND BAR
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State | CA
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Zip | 91765-2956
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Country | US
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Telephone | 909-860-2622
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Fax | 909-860-2622
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Authorized Official
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Title or Position | CEO/CFO/SECRETARY
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Name | MRS. LOURDES OFELIA AGUINALDO ABARIENTOS
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Credential |
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Telephone | 714-398-6898
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number |
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License Number State |
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