| NPI | 1417305004 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC SHAW Director 909-252-0356 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities |
| Enumeration Date | 2016-05-25 |
| Last Update Date | 2016-05-25 |