Shady Glen Facility
NPI #1003046566 in San Bernardino, California
Provider Information
- NPI Number
- 1003046566
- Entity Type
- Organization
- Organization Name
- Shady Glen Facility
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- BRIDGES IN COMMUNICATIONS, INC
- Primary Specialty
- Clinic/Center - Developmental Disabilities
- Enumeration Date
- Jul 19, 2009
- Last Updated
- Jul 29, 2009
Practice Location
- Address
- 2571 SHADY GLEN LN
- City
- San Bernardino
- State
- California
- ZIP Code
- 92408-4174
- Phone
- (909) 783-8806
Authorized Official
- Name
- MISS PATRICIA STONE
- Title
- ADMINISTRATOR
- Phone
- (909) 910-9604
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Developmental Disabilities — Developmental Disabilities |
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