# EGGLESTON YOUTH CENTERS, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Eggleston BHS - La Verne 2
- **Organization subpart:** No

## Provider details

- **NPI number:** 1801364047
- **Authorized official:** MS. CASSANDRA ELAINE GIBSON-JUDKINS LCSW (ASSISTANT EXECUTIVE DIRECTOR)
- **Authorized official phone:** (626) 480-8107

## Contact information

- **Practice address:** 790 E LA VERNE AVE, POMONA, CA 91767-2814
- **Practice address phone:** (626) 480-8107
- **Practice address fax:** (626) 869-0280
- **Mailing address:** 13001 RAMONA BLVD STE E, IRWINDALE, CA 91706-3752
- **Mailing address phone:** (626) 480-8107
- **Mailing address fax:** (626) 869-0280

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | — | — | — |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | — | — | Yes |

## Other

- **Enumeration date:** 11/06/2018
- **Last updated:** 11/06/2018