NORMANDIE PLACE NPI 1407063886

NPI Information

  • NPI: 1407063886
  • Provider Name: NORMANDIE PLACE
  • Classification: Intermediate Care Facility, Intellectual Disabilities - 315P00000X
  • Entity Type: Organization
  • CLIA Number: 05D1016892
  • Address: 14509 S NORMANDIE AVE
    GARDENA, CA
    ZIP 90247
  • Phone: (310) 767-1390

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NPI Details

NORMANDIE PLACE is an intermediate care facility mentally retarded in Gardena, CA. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. NORMANDIE PLACE NPI is 1407063886. The provider is registered as an organization entity type.

The provider's business location address is:

14509 S NORMANDIE AVE
GARDENA, CA
ZIP 90247-405
Phone: (310) 767-1390
Fax: (310) 767-1007

The provider's authorized official is Eugene Hardin .
The authorized official title is Licensee and has the following contact phone number (310) 739-3585.

The CLIA number assigned to this NPI record is 05D1016892 - skilled nursing facility/nursing facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/16/2007 and was last updated on 7/3/2008.

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
1315P00000XIntermediate Care Facility, Intellectual Disabilities960000798CALIFORNIAYes

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
11407063886OTHERCALIFORNIAMEDI-CAL

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: 11/21/2025

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