Provider Demographics
NPI:1831311901
Name:LYNWOOD DEVELOPMENTAL CARE, INC
Entity Type:Organization
Organization Name:LYNWOOD DEVELOPMENTAL CARE, INC
Other - Org Name:ARLETA HOUSE
Other - Org Type:Other Name
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MS
Authorized Official - First Name:LA VERN
Authorized Official - Middle Name:L
Authorized Official - Last Name:NEAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-223-5920
Mailing Address - Street 1:14925 SOUTH ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:E. RANCHO DOMINQUEZ
Mailing Address - State:CA
Mailing Address - Zip Code:90221
Mailing Address - Country:US
Mailing Address - Phone:310-223-5920
Mailing Address - Fax:310-223-5921
Practice Address - Street 1:3284 FLOWER ST
Practice Address - Street 2:
Practice Address - City:LYNWOOD
Practice Address - State:AL
Practice Address - Zip Code:90262
Practice Address - Country:US
Practice Address - Phone:310-884-9698
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251C00000X
CA96000955251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251C00000XAgenciesDay Training, Developmentally Disabled Services