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Organization
THE CAROLYN E. WYLIE CENTER FOR CHILDREN, YOUTH & FAMILIES
Active
Organization
THE CAROLYN E. WYLIE CENTER FOR CHILDREN, YOUTH & FAMILIES
Active
Other names
The Wylie Center
Organization subpart
No
Provider details
NPI number
Authorized official
PAMELA G JORDAN LCSW, MSLM (CHIEF EXECUTIVE OFFICER)
(951) 683-5193
Entity
Organization
Contact information
Practice address
4164 BROCKTON AVE, RIVERSIDE, CA 92501-3400
(951) 683-5193
(951) 300-1030
Mailing address
4164 BROCKTON AVE, RIVERSIDE, CA 92501-3400
(951) 683-5193
(951) 300-1030
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33BA00
ACT
CA
01
—
33BAA0
CAT
CA
Enumeration date
02/01/2007
Last updated
08/22/2020
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