NORMAL LIFE OF CALIFORNIA INC. NPI 1003943838

NPI Information

NPI: 1003943838
Provider Name: NORMAL LIFE OF CALIFORNIA, INC.

Other Name: BRIAN HOUSE

Classification: Intermediate Care Facility, Intellectual Disabilities - 315P00000X
Entity Type: Organization
Address:
1361 N BRIAN AVE
AZUSA, CA
ZIP 91702
Phone: (714) 537-3252
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NORMAL LIFE OF CALIFORNIA, INC. is an intermediate care facility mentally retarded in Azusa, CA. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. NORMAL LIFE OF CALIFORNIA, INC. NPI is 1003943838. The provider is registered as an organization entity type.
The provider Other Name Is Brian House.

The provider's business location address is:

1361 N BRIAN AVE
AZUSA, CA
ZIP 91702-802
Phone: (714) 537-3252

The provider's authorized official is Angie Mattingly .
The authorized official title is Mgr Provider Enrollment and has the following contact phone number (502) 394-2100.

The enumeration date for this NPI number is 2/28/2007 and was last updated on 3/15/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	315P00000X	Intermediate Care Facility, Intellectual Disabilities				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	LTC60935F	MEDICAID	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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