Organization · Type 2 NPI
Shady Glen Facility
Developmental Disabilities Clinic/Center · San Bernardino, CA
Practice location
2571 Shady Glen Ln
San Bernardino, CA 92408-4174
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Developmental Disabilities Clinic/Center Primary | 261QD1600X | 360911227 (CA) |
Developmental Disabilities Clinic/Center: An entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.).
About NPI 1003046566
Shady Glen Facility's National Provider Identifier is 1003046566, issued on Jul 19, 2009. The primary taxonomy on file is Developmental Disabilities Clinic/Center (261QD1600X), and the practice location is in San Bernardino, CA. The record was last updated on Jul 29, 2009.