Organization
THE STAY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENT DUNLAP (MHS II/ AC)
(909) 763-4760
Entity
Organization
Contact information
Practice address
780 E GILBERT ST, SAN BERNARDINO, CA 92415-1003
(909) 763-4760
Mailing address
780 E GILBERT ST, SAN BERNARDINO, CA 92415-1003
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
106H00000X
CA
Other
Enumeration date
08/25/2016
Last updated
08/25/2016
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