UNITED CARE PROVIDERS-HOLY INFANT
Intermediate Care Facility, Mentally Retarded
Baldwin Park, California
Provider NPI: 1417928458
Organization Information:Organization Name: UNITED CARE PROVIDERS-HOLY INFANT
Practice Location:
4710 KENMORE AVE BALDWIN PARK, CA 91706 US
Tel: 626-962-8568 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
4710 KENMORE AVE BALDWIN PARK, CA 91706 US
Tel: 626-962-8568 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 315P00000X | Nursing & Custodial Care Facilities Intermediate Care Facility, Mentally Retarded | CA | 96000054 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
LTC80016F | CA | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin