Loleta Guest Home, Icf-Ddn - Health Care Facilities in California

Health Care Facilities in California

Here you can find all the California healthcare facilities that are operational and have a current license issued by the California Department of Public Health and/or a current U.S. Department of Health and Human Services’ Centers for Medicare and Medicaid Services (CMS) certification. (Source: Center for Health Care Quality, California Department of Public Health. 2018. HealthcareFacilities-California_2018-09-05-CA-CDPH).

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Loleta Guest Home, Icf-Ddn - Health Care Facilities in California

Facility Administrator's Fax Number	(323) 478-1456
Facility Administrator's Phone Number	(323) 376-1468
County	LOS ANGELES
District Office That Oversees The Facility	LA ICF/DD/CLINICS
License Number	550001961
Business Name	MODEL RESIDENTIAL HOME, INC.
Initial License Date	11-Jun-12
License Effective Date	11-Jun-19
License Expiration Date	10-Jun-20
Entity Type	PROFIT CORP
Street Number	5129
Street Name	LOLETA AVE
Local Health Jurisdiction Name	LOS ANGELES
Fips County Code	037
Facility Identification #	630013452
Health Care Facility Name	LOLETA GUEST HOME, ICF-DDN
Facility Type	INTERMEDIATE CARE FACILITY-DD/H/N/CN/IID
Capacity (Number Or Licensed Beds)	6
Address	5129 LOLETA AVE
City	LOS ANGELES
Zip	90041
Zip9	1501
Facility Administrator	MORENO, DENNIS B
Facility Administrator's E-Mail	EVELYN_MORENO1@HOTMAIL.COM