PROTOTYPES

POMONA, CA
NPI1265069355
Entity TypeOrganization
Authorized ContactEVANNE BREE JACKSON
Sud Counselor Ii
909-624-1233
Organization Subpart ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2020-03-26
Last Update Date2020-03-27
Business Address
PROTOTYPES
831 E ARROW HWY
POMONA, CA 91767-2535
Phone number: 909-624-1233
Mailing Address
PROTOTYPES
831 E ARROW HWY
POMONA, CA 91767-2535
Phone number: 909-624-1233