05D2280669 CLIA NUMBER - VALLEY STAR RANCHO LOS AMIGOS CRISIS RESIDENTIAL TREATMENT

Laboratory Demographics

CLIA Number: 05D2280669

Facility Name: VALLEY STAR RANCHO LOS AMIGOS CRISIS RESIDENTIAL TREATMENT

Facility Address:
7735 LEEDS ST
DOWNEY, CA
ZIP 90242
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Facility Phone Number: 562 719-2865

Facility Type: Other - CRISIS RESIDENTIAL TREATM

Certificate Type: Waiver

NPI Number: 1396491973

Taxonomy: 251S00000X - Community/Behavioral Health
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.

CLIA Record

Field Name	Field Value
CLIA Number	05D2280669
LAB Type	Other - CRISIS RESIDENTIAL TREATM
Facility Name	VALLEY STAR RANCHO LOS AMIGOS CRISIS RESIDENTIAL TREATMENT
Street	7735 LEEDS ST
City	DOWNEY
State	CA
ZIP	90242
Phone	562 719-2865
CertificateType	4
CertificateEffectiveDate	4/24/2023
CertificateExpirationDate	4/23/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024