| NPI | 1417143983 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL A. TIPTON Accounts Receivable Specialist 909-484-5561 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310500000X Intermediate Care Facility, Mental Illness (Licence: CA 240000038) |
| Enumeration Date | 2007-09-19 |
| Last Update Date | 2007-09-19 |