OrganizationActive
126th Street Homes, Inc. - Loop Home I
NPI 1013125228 · Intellectual Disabilities Intermediate Care Facility · Hawthorne, CA
Provider details
- NPI number
- 1013125228
- Entity type
- Organization
- Primary specialty
- Intellectual Disabilities Intermediate Care FacilityNursing & Custodial Care Facilities
- Authorized official
- Tony Dojcinovic, Licensee
Practice location
4180 W 126th St
Hawthorne, CA 90250-4547
Phone: (310) 676-7634
Fax: (310) 808-0883
Mailing address
15920 S Dalton Ave
Gardena, CA 90247-3908
Registry dates
- Enumerated
- 2007-05-19
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.