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Organization
WOOD DRAGON INN LLC
Active
Organization
WOOD DRAGON INN LLC
Active
Other names
Mental Health Residential
Organization subpart
No
Provider details
NPI number
Authorized official
TYLER PENROD (CONSULTANT)
(305) 900-4715
Entity
Organization
Contact information
Practice address
53295 OATES LANE, IDYLLWILD, CA 92549
(800) 750-2613
Mailing address
2224 GREENLEAF ST, SANTA ANA, CA 92706-2536
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
—
—
Other
Enumeration date
02/23/2024
Last updated
08/12/2024
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