| NPI | 1700577137 |
|---|---|
| Other Name | BOYS REPUBLIC - MCCORMICK STRTP |
| Entity Type | Organization |
| Authorized Contact | WAYNE STEMMLER Clinical Supervisor/Head Of Service 909-315-9097 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2023-05-17 |
| Last Update Date | 2023-12-29 |