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Model Residential Home, Inc
Intellectual Disabilities Intermediate Care Facility in Los Angeles, California
NPI 1073721288

Model Residential Home, Inc is a Intellectual Disabilities Intermediate Care Facility based in Los Angeles, CA. Model Residential Home, Inc practices in Los Angeles, CA. The NPI Number for Model Residential Home, Inc is 1073721288 and holds a License No. 960001042 (California).

The current practice location address for Model Residential Home, Inc is 2227 Laverna Ave, Los Angeles, CA and can be reached out via phone at 323-254-3621 and via fax at 323-254-3655.

Location: 2227 Laverna Ave, Los Angeles, CA, 90041-2624
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1073721288
Provider Name
Model Residential Home, Inc
Credential
Provider Entity Type
Organization
Address
2227 Laverna Ave, Los Angeles, CA, 90041-2624
Phone Number
323-254-3621
Fax Number
323-254-3655
Provider Enumeration Date
05/19/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
2227 Laverna Ave
City
Los Angeles
State
California
Zip
90041-2624
Phone Number
323-254-3621
Fax Number
323-254-3655
person
Provider Business Mailing Address Details
Address
2227 Laverna Ave
City
Los Angeles
State
California
Zip
90041-2624
Phone Number
323-254-3621
Fax Number
323-254-3655
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Intermediate Care Facility, Mentally Retarded
Speciality
-
Taxonomy
315P00000X
License No.
960001042 (California)
Definition
(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals.
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