Organization
PINE RIDGE TREATMENT CENTERS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WALTER GILES (PRESIDENT/OWNER)
(909) 867-4404
Entity
Organization
Contact information
Practice address
15367 BONANZA RD, STE A, VICTORVILLE, CA 92392
(760) 955-1012
(760) 955-4811
Mailing address
PO BOX 959, LUCERNE, CA 95458-0959
(760) 248-9199
(760) 248-6479
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
06/11/2019
Last updated
06/11/2019
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