| NPI | 1003068479 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEISY ODETT MENDOZA Executive Director 909-912-9314 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities (Licence: CA 240000825) |
| Enumeration Date | 2008-10-16 |
| Last Update Date | 2025-06-18 |