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General NPI Number Information
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NPI Number | 1912992637
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Entity Type | Organization
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Legal Business Name | SANTA TERESITA, INC.
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Dates
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Enumeration Date | 09/19/2005
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Last Update Date | 10/27/2014
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Provider Practice Location Address
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Address Line | 819 BUENA VISTA ST
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City | DUARTE
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State | CA
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Zip | 91010-1703
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Country | US
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Telephone | 626-408-7802
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Fax | 626-408-7874
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Provider Business Mailing Address
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Address Line | 819 BUENA VISTA ST
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City | DUARTE
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State | CA
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Zip | 91010-1703
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Country | US
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Telephone | 626-408-7802
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Fax | 626-408-7874
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Authorized Official
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Title or Position | CONTROLLER
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Name | MS. SISTER MARGARET MARY
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Credential |
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Telephone | 626-289-1353
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 950000125
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License Number State | CA
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