Organization
ALPHA RESIDENTIAL INC
Active
Other names
San Bernardino House
Organization subpart
No
Provider details
NPI number
Authorized official
VINCENT OKORAFOR (PRESIDENT)
(909) 629-1829
Entity
Organization
Contact information
Practice address
692 SAN BERNARDINO AVE, POMONA, CA 91767-3244
(909) 620-2585
(909) 622-2090
Mailing address
PO BOX 2220, POMONA, CA 91769-2220
(909) 815-1129
(909) 622-2090
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
550002479
CA
Other
Enumeration date
10/11/2017
Last updated
03/17/2018
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