| NPI | 1902611585 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANTE BAUTISTA Manager 951-878-7027 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities |
| Enumeration Date | 2025-02-11 |
| Last Update Date | 2025-02-11 |