| NPI | 1083404909 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GABRIEL ANTHONY DITA CONVENTO CEO 951-289-0180 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 251V00000X Voluntary or Charitable |
| 251X00000X Supports Brokerage | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| 385H00000X Respite Care | |
| 174200000X Meals | |
| 177F00000X Lodging | |
| 251B00000X Case Management | |
| 251K00000X Public Health or Welfare | |
| Enumeration Date | 2025-05-12 |
| Last Update Date | 2025-06-16 |