Organization
ORCHID COURT, INC.
Active
Other names
Vanda Royale
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CLODOVEO R. GOSUICO III (ADMINISTRATOR)
(909) 884-3044
Entity
Organization
Contact information
Practice address
2020 WEST MESA STREET, SAN BERNARDINO, CA 92407-6538
(909) 887-6287
(909) 887-6287
Mailing address
2020 WEST MESA STREET, SAN BERNARDINO, CA 92407-6538
(909) 887-6287
(909) 887-6287
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
11/23/2020
Last updated
11/23/2020
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