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Our Lady Of Guadalupe
Intellectual Disabilities Intermediate Care Facility in Port Hueneme, California
NPI 1447224381

Our Lady Of Guadalupe is a Intellectual Disabilities Intermediate Care Facility based in Glendale, CA. Our Lady Of Guadalupe practices in Port Hueneme, CA. The NPI Number for Our Lady Of Guadalupe is 1447224381 and holds a License No. (California).

The current practice location address for Our Lady Of Guadalupe is 1474 N 5Th St, Port Hueneme, CA and can be reached out via phone at 805-487-9757 and via fax at 805-487-9757.

Location: 1474 N 5Th St, Port Hueneme, CA, 91206-1811
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1447224381
Provider Name
Our Lady Of Guadalupe
Credential
Provider Entity Type
Organization
Address
1474 N 5Th St, Port Hueneme, CA, 91206-1811
Phone Number
805-487-9757
Fax Number
805-487-9757
Provider Enumeration Date
02/15/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
LTC60799F 05 CA
institution
Provider Business Practice Location Address Details
Address
1474 N 5Th St
City
Port Hueneme
State
California
Zip
93041-2205
Phone Number
805-487-9757
Fax Number
805-487-9757
person
Provider Business Mailing Address Details
Address
1474 N 5Th St
City
Port Hueneme
State
California
Zip
93041-2205
Phone Number
805-487-9757
Fax Number
805-487-9757
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Intermediate Care Facility, Mentally Retarded
Speciality
-
Taxonomy
315P00000X
License No.
(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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