Organization
EAST VALLEY GLENDORA HOSPITAL LLC
Active
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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