Organization
BITHIAHS HOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEITH THOMPSON (EXECUTIVE DIRECTOR)
(909) 631-8677
Entity
Organization
Contact information
Practice address
1706 WINEGLOW CIR, WALNUT, CA 91789-3544
(909) 595-3419
(909) 444-3379
Mailing address
1706 WINEGLOW CIR, WALNUT, CA 91789-3544
(909) 595-3419
(909) 444-3379
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
197806776
CA
Other
Enumeration date
05/29/2018
Last updated
05/29/2018
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