| NPI | 1134693153 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNETTE PUNIMATA Executive Director 909-992-0929 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 253J00000X Foster Care Agency |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2019-01-12 |
| Last Update Date | 2022-04-21 |