| NPI | 1982080446 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON CARL JIMENEZ Executive Director 909-379-9680 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization |
| Additional Taxonomies | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Enumeration Date | 2015-08-07 |
| Last Update Date | 2025-09-22 |