MCLENNAN AVENUE HOME NPI 1629560263

NPI Information

  • NPI: 1629560263
  • Provider Name: MCLENNAN AVENUE HOME
  • Classification: Intermediate Care Facility, Intellectual Disabilities - 315P00000X
  • Entity Type: Organization
  • Address: 12325 MCLENNAN AVE
    GRANADA HILLS, CA
    ZIP 91344
  • Phone: (818) 886-3172

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NPI Details

MCLENNAN AVENUE HOME is an intermediate care facility mentally retarded in Granada Hills, CA. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. MCLENNAN AVENUE HOME NPI is 1629560263. The provider is registered as an organization entity type.

The provider's business location address is:

12325 MCLENNAN AVE
GRANADA HILLS, CA
ZIP 91344-716
Phone: (818) 886-3172
Fax: (747) 300-9108

The provider's authorized official is Roy L Martin .
The authorized official title is President and has the following contact phone number (323) 253-5316.

The enumeration date for this NPI number is 5/30/2018 and was last updated on 1/16/2024.

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
1320600000XResidential Treatment Facility, Intellectual and/or Developmental DisabilitiesNo
2315P00000XIntermediate Care Facility, Intellectual DisabilitiesYes

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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