| NPI | 1588557268 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAYRA MARTINEZ L PT 909-763-4760 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2025-05-31 |
| Last Update Date | 2025-05-31 |