Provider Demographics
NPI:1790015063
Name:IN HONOR OF OUR PARENTS
Entity Type:Organization
Organization Name:IN HONOR OF OUR PARENTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSEE/ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:LOVE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-805-8799
Mailing Address - Street 1:1133 W 40TH PL
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90037-1802
Mailing Address - Country:US
Mailing Address - Phone:323-296-7816
Mailing Address - Fax:323-296-7816
Practice Address - Street 1:1133 W 40TH PL
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90037-1802
Practice Address - Country:US
Practice Address - Phone:323-296-7816
Practice Address - Fax:323-296-7816
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-08
Last Update Date:2010-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA197607238310400000X, 311Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility