| NPI | 1265663801 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHIZUKO KAMIYAMA ALTEMUS Careprovider 951-780-3924 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: CA 336400918) |
| Enumeration Date | 2009-07-30 |
| Last Update Date | 2009-07-30 |