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
13434 REINDEER ST, MORENO VALLEY, CA 92553-3291
(951) 243-5129
Mailing address
11751 DAVIS ST, MORENO VALLEY, CA 92557-6316
(951) 485-2642
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
250000343
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LTC60669F
LTC PROVIDER
CA
Enumeration date
01/10/2007
Last updated
06/17/2008
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