Organization
EGGLESTON YOUTH CENTERS, INC.
Active
Parent organization
EGGLESTON YOUTH CENTERS, INC.
Other names
Eggleston BHS - Covina
Organization subpart
Yes
Provider details
NPI number
Legal business name
EGGLESTON YOUTH CENTERS, INC.
Authorized official
CASSANDRA ELAINE GIBSON-JUDKINS LCSW (ASSISTANT EXECUTIVE DIRECTOR)
(626) 480-8107
Entity
Organization
Contact information
Practice address
340 N WESTRIDGE AVE, COVINA, CA 91724-2921
(626) 480-8107
(626) 869-0280
Mailing address
13001 RAMONA BLVD STE E, IRWINDALE, CA 91706-3752
(626) 480-8107
(626) 869-0280
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
197806369
CA
Other
Enumeration date
01/26/2017
Last updated
10/02/2018
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