# ETTIE LEE HOMES, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Ettie Lee Youth and Family Services
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356975148
- **Authorized official:** WINDY LUNA PEREZ (QA MANAGER)
- **Authorized official phone:** (909) 620-2521

## Contact information

- **Practice address:** 11282 SPRUCE AVE, BLOOMINGTON, CA 92316-3228
- **Practice address phone:** (909) 877-3330
- **Practice address fax:** (909) 355-6678
- **Mailing address:** 160 E HOLT AVE STE B, POMONA, CA 91767-5407
- **Mailing address phone:** (909) 620-2521
- **Mailing address fax:** (909) 620-9793

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | — | — | Yes |

## Other

- **Enumeration date:** 03/02/2020
- **Last updated:** 10/23/2024