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General NPI Number Information
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NPI Number | 1316862519
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Entity Type | Organization
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Legal Business Name | SPARKS WINN
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Dates
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Enumeration Date | 08/13/2026
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Last Update Date | 08/13/2026
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Provider Practice Location Address
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Address Line | 4515 W 137TH PL
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City | HAWTHORNE
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State | CA
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Zip | 90250-6907
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Country | US
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Telephone | 310-679-5900
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Fax |
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Provider Business Mailing Address
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Address Line | 1107 S LA BREA AVE
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City | INGLEWOOD
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State | CA
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Zip | 90301-3819
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Country | US
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Telephone | 310-679-5900
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. ANNETTA LENISE SPARKS
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Credential |
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Telephone | 310-679-5900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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