L. MARILLAC GROUP HOME NPI 1679781884

NPI Information

L. MARILLAC GROUP HOME is an intermediate care facility mentally retarded in Diamond Bar, CA. The provider is (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. L. MARILLAC GROUP HOME NPI is 1679781884. The provider is registered as an organization entity type.

The provider's business location address is:

23711 PROSPECT VALLEY DR
DIAMOND BAR, CA
ZIP 91765-637
Phone: (909) 821-3698
Fax: (909) 860-7614

The provider's authorized official is Grace Villegas .
The authorized official title is Licensee and has the following contact phone number (909) 821-3698.

The enumeration date for this NPI number is 5/19/2007 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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