| NPI | 1194312876 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY K KIILU Official 909-441-9520 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2020-12-28 |
| Last Update Date | 2020-12-30 |