| NPI | 1043784069 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNETTE PUNIMATA Executive Director 909-992-0929 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 251B00000X Case Management |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children | |
| Enumeration Date | 2019-01-12 |
| Last Update Date | 2022-04-21 |