Good Shepherd Lutheran Home of the West

NPI #1194876359 in Lake Forest, California

Provider Information

NPI Number
1194876359
Entity Type
Organization
Organization Name
Good Shepherd Lutheran Home of the West
Primary Specialty
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date
Jan 15, 2007
Last Updated
Apr 29, 2008

Practice Location

Address
26489 RANCHO PKWY S
ZIP Code
92630-8326
Phone
(949) 855-8056

Authorized Official

Name
MR. JEFFREY A. KACZMARSKI
Title
CHIEF LEGAL AFFAIRS OFFICER
Phone
(920) 206-4406

Specialties & Taxonomy Codes

Specialty
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

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