Organization
BOURNE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIM TUCKER (CEO)
(626) 797-9196
Entity
Organization
Contact information
Practice address
3082 THURIN AVE, ALTADENA, CA 91001-4228
(626) 797-1706
(626) 797-9185
Mailing address
2235 LAKE AVE STE 212, ALTADENA, CA 91001-6041
(626) 797-9196
(626) 345-9970
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
03/01/2018
Last updated
03/19/2019
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