Wanda
NPI #1538322656 in Rialto, California
Provider Information
- NPI Number
- 1538322656
- Entity Type
- Organization
- Organization Name
- Wanda
- Primary Specialty
- Residential Treatment Facility, Physical Disabilities
- Enumeration Date
- Jul 9, 2008
- Last Updated
- Sep 6, 2023
Practice Location
- Address
- 3730 FERNWOOD AVE
- City
- Rialto
- State
- California
- ZIP Code
- 92377-2724
- Phone
- (909) 823-3703
Authorized Official
- Name
- MS. WANDA JEAN SMITH, LVN
- Title
- LVN
- Phone
- (909) 496-2440
Specialties & Taxonomy Codes
| Specialty |
|---|
| Residential Treatment Facility, Physical Disabilities |
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