MODEL RESIDENTIAL HOME, INC. is an intermediate care facility mentally retarded in Los Angeles, CA. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. MODEL RESIDENTIAL HOME, INC. NPI is 1356619019. The provider is registered as an organization entity type.
The provider Is Doing Business As Loleta Guest Home.
The provider's business location address is:
5129 LOLETA AVE
LOS ANGELES, CA
ZIP 90041-501
Phone: (323) 254-3621
Fax: (323) 254-3655
The provider's authorized official is Evelyn Moreno .
The authorized official title is Owner/licensee and has the following contact phone number (323) 254-3621.
The enumeration date for this NPI number is 12/9/2011 and was last updated on 12/9/2011.