Organization
PROVIDENCE RESPITE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BEATRIZ GABRIELLE (OWNER)
(909) 813-3793
Entity
Organization
Contact information
Practice address
400 N MOUNTAIN AVE STE 123C, UPLAND, CA 91786-5176
(909) 813-3783
Mailing address
400 N MOUNTAIN AVE STE 123C, UPLAND, CA 91786-5176
(909) 813-3783
Taxonomy
Speciality
Code
Description
License number
State
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
—
—
Other
Enumeration date
10/25/2021
Last updated
10/25/2021
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