Organization
PEPPERMINT RIDGE DUDLEY HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AUDREY TURNER REV. (INTERIM EXECUTIVE DIRECTOR)
(951) 273-7320
Entity
Organization
Contact information
Practice address
4289 SHOALCREEK DR, CORONA, CA 92883-0724
(951) 273-7320
(951) 737-0726
Mailing address
825 MAGNOLIA AVE, CORONA, CA 92879-3129
(951) 273-7320
(951) 737-0726
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
02/11/2010
Last updated
02/11/2010
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