Organization
ETTIE LEE HOMES, INC
Active
Other names
Ettie Lee Homes Pomona
Organization subpart
No
Provider details
NPI number
Authorized official
WINDY LUNA PEREZ (QA MANAGER)
(909) 620-2521
Entity
Organization
Contact information
Practice address
160 E HOLT AVE STE B, POMONA, CA 91767-5407
(909) 620-2521
(909) 620-9793
Mailing address
303 W FOOTHILL BLVD STE 13, GLENDORA, CA 91741-3386
(626) 960-4861
(626) 960-6241
Taxonomy
Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
C07933
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
36IHCR
SBCDBH
CA
01
—
7453A
LACDMH
CA
Enumeration date
10/04/2006
Last updated
10/24/2024
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