# ERICA B INDEPENDENT LIVING FACILITY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** ERICA B INDEPENDENT LIVING FACILITY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780434829
- **Authorized official:** ERICA RENE GRAHAM-BULLOCK (OWNER / ADMINISTRATOR)
- **Authorized official phone:** (818) 818-1817

## Contact information

- **Practice address:** 3656 GINGER ST, PERRIS, CA 92571-7825
- **Practice address phone:** (951) 226-1750
- **Practice address fax:** (951) 200-4761
- **Mailing address:** PO BOX 57, PERRIS, CA 92572-0057
- **Mailing address phone:** (951) 226-1750
- **Mailing address fax:** (951) 200-4761

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251C00000X | Developmentally Disabled Services Day Training Agency | — | NULL | — |
| 251G00000X | Community Based Hospice Care Agency | — | NULL | — |
| 310400000X | Assisted Living Facility | — | NULL | — |
| 3104A0625X | Assisted Living Facility (Mental Illness) | — | NULL | — |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | NULL | Yes |
| 320900000X | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | — | NULL | — |
| 373H00000X | Day Training/Habilitation Specialist | — | NULL | — |
| 385H00000X | Respite Care | — | NULL | — |

## Other

- **Enumeration date:** 03/22/2024
- **Last updated:** 10/02/2026