Organization
KAISER FOUNDATION HOSPITALS
Active
Other names
Kaiser Foundation Hospital Chem Dependency Recovery
Organization subpart
No
Provider details
NPI number
Authorized official
RUTH COUNTS MHA, RN, CPHQ (INTERIM DIRECTOR ARL)
(626) 405-3676
Entity
Organization
Contact information
Practice address
17046 MARYGOLD AVE, FONTANA, CA 92335-1706
(909) 427-5128
Mailing address
17046 MARYGOLD AVE, FONTANA, CA 92335-1706
(909) 427-5128
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
240000159
CA
Other
Enumeration date
01/23/2007
Last updated
04/20/2021
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