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
- City
- Lake Forest
- State
- California
- 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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