WINTER HAVEN NPI 1154392181

NPI Information

WINTER HAVEN is an intermediate care facility mentally retarded in Fillmore, CA. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. WINTER HAVEN NPI is 1154392181. The provider is registered as an organization entity type.

The provider's business location address is:

546 CENTRAL AVE
FILLMORE, CA
ZIP 93015-332
Phone: (805) 524-3040
Fax: (805) 524-3040

The provider's authorized official is Kathleen Elbanowski .
The authorized official title is Ceo/cfo and has the following contact phone number (805) 525-0305.

The CLIA number assigned to this NPI record is 05D1080645 - intermediate care facility for mentally retarded with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/28/2006 and was last updated on 8/22/2020.

Taxonomy Codes

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Other Identifiers

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