Provider Demographics
NPI:1417638750
Name:KITTRIDGE RCFE LLC.
Entity Type:Organization
Organization Name:KITTRIDGE RCFE LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSEE/ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:FRANCIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-494-2899
Mailing Address - Street 1:20702 KITTRIDGE ST.
Mailing Address - Street 2:
Mailing Address - City:WINNETKA
Mailing Address - State:CA
Mailing Address - Zip Code:91306
Mailing Address - Country:US
Mailing Address - Phone:626-494-2899
Mailing Address - Fax:310-496-1830
Practice Address - Street 1:20702 KITTRIDGE ST.
Practice Address - Street 2:
Practice Address - City:WINNETKA
Practice Address - State:CA
Practice Address - Zip Code:91306
Practice Address - Country:US
Practice Address - Phone:626-494-2899
Practice Address - Fax:310-496-1830
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KITTRIDGE RCFE LLC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-07-28
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities