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General NPI Number Information
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NPI Number | 1689714214
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Entity Type | Organization
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Legal Business Name | C.L.O., INC.
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 24761 VIA LARGA
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City | LAGUNA NIGUEL
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State | CA
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Zip | 92677-1933
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Country | US
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Telephone | 949-458-1881
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Fax | 949-581-4959
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Provider Business Mailing Address
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Address Line | 24761 VIA LARGA
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City | LAGUNA NIGUEL
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State | CA
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Zip | 92677-1933
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Country | US
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Telephone | 949-458-1881
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Fax | 949-581-4959
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | TERRY L WARD
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Credential |
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Telephone | 949-458-1881
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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 |
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 315P00000X
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Taxonomy Name | Intellectual Disabilities Intermediate Care Facility
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License Number |
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 315P00000X
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Taxonomy Name | Intellectual Disabilities Intermediate Care Facility
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License Number |
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License Number State | CA
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