Brandon J Inc/serenity Place

NPI #1700024098 in Colton, California

Provider Information

NPI Number: 1700024098
Entity Type: Organization
Organization Name: Brandon J Inc/serenity Place
Primary Specialty: Counselor
Enumeration Date: Jan 26, 2009
Last Updated: Jan 26, 2009

Practice Location

Address: 128 E G ST STE 111
City: Colton
State: California
ZIP Code: 92324-2943
Phone: (909) 430-0922

Authorized Official

Name: MRS. LOURDES A LEFEVRE, CERTIFICATE
Title: EXECUTIVE DIRECTOR
Phone: (909) 430-0922

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X	Primary

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