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Organization

BRANDON J INC/SERENITY PLACE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. LOURDES A LEFEVRE CERTIFICATE (EXECUTIVE DIRECTOR)
(909) 430-0922
Entity
Organization

Contact information

Practice address
128 E G ST STE 111, COLTON, CA 92324-2943
(909) 430-0922
Mailing address
128 E. G ST. #111, COLTON, CA 92324
(909) 430-0922
(909) 430-0923

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
368607
CA

Other

Enumeration date
01/26/2009
Last updated
01/26/2009
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