BIXBY KNOLL PLACE NPI 1427265800

NPI Information

BIXBY KNOLL PLACE is an intermediate care facility mentally retarded in Long Beach, CA. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. BIXBY KNOLL PLACE NPI is 1427265800. The provider is registered as an organization entity type.

The provider's business location address is:

3706 PINE AVE
LONG BEACH, CA
ZIP 90807-258
Phone: (562) 595-9713
Fax: (562) 595-0101

The provider's authorized official is Smyrna Dojcinovic .
The authorized official title is Licensee and has the following contact phone number (310) 808-0883.

The CLIA number assigned to this NPI record is 05D2062986 - intermediate care facility for mentally retarded with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/16/2007 and was last updated on 8/22/2020.

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:

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