Organization
EAST VALLEY GLENDORA HOSPITAL LLC
Active
Other names
Glendora Community Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL A. HEATHER (CFO)
(909) 235-4332
Entity
Organization
Contact information
Practice address
150 W ROUTE 66, GLENDORA, CA 91740-6207
(626) 852-6125
(626) 852-5055
Mailing address
3300 E GUASTI RD FL 3, ONTARIO, CA 91761-8655
(909) 235-4400
(909) 235-4419
Taxonomy
Speciality
Code
Description
License number
State
273R00000X
Psychiatric Hospital Unit
Primary
930000060
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
HSM30205I
—
CA
05
—
ZZT30205I
—
CA
Enumeration date
02/28/2007
Last updated
06/21/2017
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