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General NPI Number Information
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NPI Number | 1417121310
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Entity Type | Organization
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Legal Business Name | TEMPLE GARDEN HOMES FOR THE DEVELOPMENTALLY DISABLED, INC
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Dates
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Enumeration Date | 04/22/2008
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Last Update Date | 04/22/2008
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Provider Practice Location Address
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Address Line | 4675 YORK BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90041-3342
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Country | US
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Telephone | 323-359-9633
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Fax | 626-444-6090
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Provider Business Mailing Address
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Address Line | 5120 BALDWIN AVE
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City | TEMPLE CITY
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State | CA
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Zip | 91780-3901
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Country | US
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Telephone | 626-444-2836
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Fax | 626-444-6090
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Authorized Official
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Title or Position | CEO
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Name | MRS. FLORENCIA I. PILPA
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Credential | RN, MS
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Telephone | 626-444-2836
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 315P00000X
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Taxonomy Name | Intellectual Disabilities Intermediate Care Facility
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License Number | 960001444
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License Number State | CA
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