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Organization

WHITEHEAD PRIVATE CARE SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
AURELIA WHITEHEAD (OWNER)
(562) 544-7618
Entity
Organization

Contact information

Practice address
15486 DAYBREAK LN, FONTANA, CA 92337-0976
(909) 357-8008
Mailing address
15486 DAYBREAK LN, FONTANA, CA 92337-0976

Taxonomy

Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary

Other

Enumeration date
08/30/2009
Last updated
08/30/2009
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