Organization
MSJI HOME INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAYDEV BHAVSAR (ADMINISTRATOR)
(909) 592-6003
Entity
Organization
Contact information
Practice address
1324 JUANITA AV, SANDIMAS, CA 91773
(909) 592-6003
(909) 592-3432
Mailing address
P.O. BOX 4861, SANDIMAS, CA 91773
(909) 592-6003
(909) 592-3432
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
197801816
CA
Other
Enumeration date
08/04/2009
Last updated
08/04/2009
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