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General NPI Number Information
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NPI Number | 1518007970
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Entity Type | Organization
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Legal Business Name | IMPERIAL PARK, INC
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 10/20/2025
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Provider Practice Location Address
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Address Line | 3323 E IMPERIAL HWY
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City | LYNWOOD
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State | CA
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Zip | 90262-3305
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Country | US
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Telephone | 310-638-6691
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Fax |
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Provider Business Mailing Address
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Address Line | 3323 E IMPERIAL HWY
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City | LYNWOOD
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State | CA
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Zip | 90262-3305
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Country | US
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Telephone | 310-631-6122
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Fax |
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Authorized Official
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Title or Position | AR SYSTEMS MANAGER
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Name | ANA MARIA CANDELAS
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Credential |
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Telephone | 949-740-3454
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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 | 960001047
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License Number State | CA
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