| NPI | 1356082325 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIMMON O. B. LOGAN CEO/President 951-413-4908 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Enumeration Date | 2022-04-05 |
| Last Update Date | 2022-04-05 |