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215 W La Verne Ave Pomona CA 91767-2333 | |
| (626) 480-8107 | |
| (626) 869-0280 |
| Full Name | |
|---|---|
| Speciality | Residential Treatment Facility, Emotionally Disturbed Children |
| Location | 215 W La Verne Ave, Pomona, California |
| Authorized Official Name and Position | Cassandra Elaine Gibson-judkins (ASSISTANT EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6264808107 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
13001 Ramona Blvd Ste E Irwindale CA 91706-3752 Ph: (626) 480-8107 | 215 W La Verne Ave Pomona CA 91767-2333 Ph: (626) 480-8107 |
| NPI Number | 1689111809 |
|---|---|
| Provider Enumeration Date | 01/25/2017 |
| Last Update Date | 10/02/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689111809 | NPI | - | NPPES |
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