Organization
VAN HORN YOUTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMANTHA LILLO (CLINICAL THERAPIST)
(951) 928-5568
Entity
Organization
Contact information
Practice address
22964 PABLO, NUEVO, CA 92567-9635
(951) 928-5568
Mailing address
22964 PABLO, NUEVO, CA 92567-9635
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
ASW 20410
CA
Other
Enumeration date
09/20/2006
Last updated
08/22/2020
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