| NPI | 1477784767 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAYDEV BHAVSAR Administrator 909-592-6003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities (Licence: CA 197801815) |
| Enumeration Date | 2009-08-04 |
| Last Update Date | 2009-08-11 |