Model Residential Home, Inc.

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

Legal business name

MODEL RESIDENTIAL HOME, INC.

Practice address

1621 Linda Rosa Ave
Los Angeles, CA 90041-2225

Phone

(323) 254-3621

Fax

(323) 254-3655

NPI assigned

Feb 24, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Evelyn Moreno

Title

Owner/Licensee

Phone

(323) 254-3621

Specialties & licenses 1

Addresses

Other names 1

• LINDA ROSA GUEST HOME Doing business as

Tax ID family

Laverna Guest Home3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Model Residential Home, Inc

  • Intellectual Disabilities Intermediate Care Facility
  • Los Angeles, CA
  • NPI 1073721288
  NPD tax ID
• Model Residential Home, Inc.

  • Intellectual Disabilities Intermediate Care Facility
  • Los Angeles, CA
  • NPI 1356619019
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1330041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330041600000",
    "number": "1427322304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1963 LA FREMONTIA ST",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910304226",
            "telephone_number": "323-254-3621",
            "fax_number": "323-254-3655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1621 LINDA ROSA AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900412225",
            "telephone_number": "323-254-3621",
            "fax_number": "323-254-3655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODEL RESIDENTIAL HOME, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-24",
        "last_updated": "2012-02-24",
        "status": "A",
        "authorized_official_last_name": "MORENO",
        "authorized_official_first_name": "EVELYN",
        "authorized_official_title_or_position": "OWNER/LICENSEE",
        "authorized_official_telephone_number": "323-254-3621"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LINDA ROSA GUEST HOME",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Zoe Moctezuma
• Mary Alice Modders, FNP
• Alison Mode, MSW
• Model Residential Home, Inc
• Model Residential Home, Inc.
• Modern Concepts Medical Group, Inc
• Modern Concepts Medical Group, Inc
• Modern Sleep Centers LLC
• Modesola Akinbi
• Pamela Modeste, RDT, MS

• Intellectual Disabilities Intermediate Care Facility in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Intellectual Disabilities Intermediate Care Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.