# SAN GABRIEL CHILDREN'S CENTER, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** SGCC-Nearfield Home-AC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730631649
- **Authorized official:** MR. PORFIRIO RINCON (CEO)
- **Authorized official phone:** (626) 859-2089

## Contact information

- **Practice address:** 952 E NEARFIELD ST, AZUSA, CA 91702-4751
- **Practice address phone:** (626) 859-2089
- **Practice address fax:** (626) 859-6537
- **Mailing address:** 2200 E ROUTE 66, GLENDORA, CA 91740-4659
- **Mailing address phone:** (626) 859-2089
- **Mailing address fax:** (626) 859-6537

## Taxonomy

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

## Other

- **Enumeration date:** 10/26/2016
- **Last updated:** 04/25/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0000056BJ | — | CA |