Organization
CITADEL COMMUNITY CARE FACILITIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNETTE PUNIMATA (EXECUTIVE DIRECTOR)
(909) 992-0929
Entity
Organization
Contact information
Practice address
568 N MOUNTAIN VIEW AVE, SAN BERNARDINO, CA 92401-1231
(909) 992-0929
Mailing address
568 N MOUNTAIN VIEW AVE, SAN BERNARDINO, CA 92401-1231
(909) 992-0929
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
253J00000X
Foster Care Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
3245S0500X
Children's Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
01/12/2019
Last updated
04/21/2022
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