Organization
PRIOR BOARD & CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAE LOIS PRIOR (OWNER & LICENESSE)
(951) 205-5336
Entity
Organization
Contact information
Practice address
6121 JUPITER DR., MIRA LOMA, CA 91752
(951) 685-4912
(951) 685-4912
Mailing address
6121 JUPITER, MIRA LOMA, CA 91752
(951) 685-4912
(951) 685-4912
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
330908249
CA
Other
Enumeration date
08/13/2009
Last updated
08/13/2009
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