| NPI | 1538322656 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WANDA JEAN SMITH Lvn 909-496-2440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities (Licence: CA 320700000X) |
| Enumeration Date | 2008-07-09 |
| Last Update Date | 2023-09-06 |