| NPI | 1528853421 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERICA RENA GRAHAM-BULLOCK Owner / Administrator 951-226-1750 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Enumeration Date | 2025-04-11 |
| Last Update Date | 2025-04-11 |