126th Street Homes, Inc. - Loop Home I
NPI #1013125228 in Hawthorne, California
Provider Information
- NPI Number
- 1013125228
- Entity Type
- Organization
- Organization Name
- 126th Street Homes, Inc. - Loop Home I
- Primary Specialty
- Intermediate Care Facility, Intellectual Disabilities
- Enumeration Date
- May 19, 2007
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 4180 W 126TH ST
- City
- Hawthorne
- State
- California
- ZIP Code
- 90250-4547
- Phone
- (310) 676-7634
Authorized Official
- Name
- TONY DOJCINOVIC
- Title
- LICENSEE
- Phone
- (310) 808-0883
Specialties & Taxonomy Codes
| Specialty |
|---|
| Intermediate Care Facility, Intellectual Disabilities |
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