Provider Demographics
NPI:1699813402
Name:TEMPLE GARDEN HOMES
Entity Type:Organization
Organization Name:TEMPLE GARDEN HOMES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:FLORENCIA
Authorized Official - Middle Name:I
Authorized Official - Last Name:PILPA
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MS
Authorized Official - Phone:626-444-2836
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:626-444-2836
Mailing Address - Fax:626-444-6090
Practice Address - Street 1:1507 N AVENUE 47
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90042-1613
Practice Address - Country:US
Practice Address - Phone:323-254-6991
Practice Address - Fax:323-257-7458
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA960000931315P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities