| Brandon J Inc/serenity Place | |
|
128 E G St Ste 111 Colton CA 92324-2943 | |
| (909) 430-0922 | |
| Not Available |
| Full Name | Brandon J Inc/serenity Place |
|---|---|
| Speciality | Counselor |
| Location | 128 E G St Ste 111, Colton, California |
| Authorized Official Name and Position | Lourdes A Lefevre (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9094300922 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brandon J Inc/serenity Place 128 E. G St. #111 Colton CA 92324 Ph: (909) 430-0922 | Brandon J Inc/serenity Place 128 E G St Ste 111 Colton CA 92324-2943 Ph: (909) 430-0922 |
| NPI Number | 1700024098 |
|---|---|
| Provider Enumeration Date | 01/26/2009 |
| Last Update Date | 01/26/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700024098 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | 368607 (California) | Primary |
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