Individual provider · Type 1 NPI
Erica Rene Graham-Bullock
Intellectual and/or Developmental Disabilities Residential Treatment Facility · Perris, CA
Practice location
3656 Ginger St
Perris, CA 92571-7825
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary | 320600000X | 331881331 (CA) |
Intellectual and/or Developmental Disabilities Residential Treatment Facility: A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.
Another provider at this address
About NPI 1063284875
Erica Rene Graham-Bullock's National Provider Identifier is 1063284875, issued on Oct 25, 2023. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Residential Treatment Facility (320600000X), and the practice location is in Perris, CA. The record was last updated on Oct 25, 2023.