| NPI | 1699824599 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL TIPTON Dir Of Admn Services 909-484-5561 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities (Licence: CA 240000089) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2020-08-22 |