Organization
WOOD DRAGON INN LLC
Active
Other names
Mental Health Residential
Organization subpart
No
Provider details
NPI number
Authorized official
TYLER PENROD (CONSULTANT)
(305) 900-4715
Entity
Organization
Contact information
Practice address
53295 OATES LANE, IDYLLWILD, CA 92549
(800) 750-2613
Mailing address
2224 GREENLEAF ST, SANTA ANA, CA 92706-2536
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
—
—
Other
Enumeration date
02/23/2024
Last updated
08/12/2024
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