| NPI | 1376129866 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBIN E JACOME Sr. Business Director 951-201-5914 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2021-03-23 |
| Last Update Date | 2021-05-26 |