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Organization
ETTIE LEE HOMES, INC
Active
Organization
ETTIE LEE HOMES, INC
Active
Other names
Ettie Lee Homes Pomona
Organization subpart
No
Provider details
NPI number
Authorized official
WINDY LUNA PEREZ (QA MANAGER)
(909) 620-2521
Entity
Organization
Contact information
Practice address
160 E HOLT AVE STE B, POMONA, CA 91767-5407
(909) 620-2521
(909) 620-9793
Mailing address
303 W FOOTHILL BLVD STE 13, GLENDORA, CA 91741-3386
(626) 960-4861
(626) 960-6241
Taxonomy
Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
C07933
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
36IHCR
SBCDBH
CA
01
—
7453A
LACDMH
CA
Enumeration date
10/04/2006
Last updated
10/24/2024
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