Provider Demographics
NPI:1366652158
Name:TEMPLE GARDEN HOME #3
Entity Type:Organization
Organization Name:TEMPLE GARDEN HOME #3
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSEE
Authorized Official - Prefix:
Authorized Official - First Name:FLORA
Authorized Official - Middle Name:
Authorized Official - Last Name:PILPA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-453-3898
Mailing Address - Street 1:5120 BALDWIN AVE
Mailing Address - Street 2:
Mailing Address - City:TEMPLE CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91780-3901
Mailing Address - Country:US
Mailing Address - Phone:626-453-3898
Mailing Address - Fax:
Practice Address - Street 1:9556 BROADWAY
Practice Address - Street 2:
Practice Address - City:TEMPLE CITY
Practice Address - State:CA
Practice Address - Zip Code:91780-3135
Practice Address - Country:US
Practice Address - Phone:626-292-1952
Practice Address - Fax:626-286-4402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA315P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities