| NPI | 1124585781 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FEDERICO ESCOBEDO JARQUE Clinical Director 909-628-1217 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2019-03-01 |
| Last Update Date | 2022-11-30 |