Organization
SAN GABRIEL CHILDREN'S CENTER, INC.
Active
Other names
SGCC Enid Home-AC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PORFIRIO RINCON (CEO)
(626) 859-2089
Entity
Organization
Contact information
Practice address
337 SOUTH ENID AVE, AZUSA, CA 91702-4302
(626) 859-2089
(626) 859-6537
Mailing address
1211 CENTER COURT DR STE 105, COVINA, CA 91724-3613
(626) 859-2089
(626) 859-6537
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000056BJ
—
CA
Enumeration date
10/26/2016
Last updated
12/15/2022
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