11Th Street House

LBN: Rescare California, Inc.
11Th Street House is an health care organization with primary practice located at 321 E 11Th St , Azusa CA 91702-2100. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded, which is considered as the primary health care specialty. Rescare California, Inc. can be contacted via phone (714) 537-3252, or through Mattingly, Angie via phone (502) 394-2100.

Contact Information

Primary practice address
321 E 11Th St Azusa CA 91702-2100
Phone: (714) 537-3252
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Mattingly, Angie
Phone: (502) 394-2100

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded 315P00000X

Profile Details

NPI number 1518094812
LBN Legal business name Rescare California, Inc.
DBA Doing business as 11Th Street House
Authorized official Mattingly, Angie
Entity Organization
Organization subpart 1 No
Enumeration date Feb 27th, 2007
Last updated Mar 15th, 2024 - about 8 months ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518094812 NPPES
California MEDICAID LTC60954F

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