Organization
DEVELOPMENTAL CLIENT CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARL E ROWE PHARM MD (PRESIDENT)
(951) 243-5129
Entity
Organization
Contact information
Practice address
12867 FOXDALE DR, MORENO VALLEY, CA 92553-5674
(951) 243-5129
(951) 485-2642
Mailing address
11751 DAVIS ST, MORENO VALLEY, CA 92557-6316
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
250000293
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LTC60343G
LTC PROVIDER NO.
CA
Enumeration date
01/09/2007
Last updated
06/17/2008
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