Organization · Type 2 NPI

Connie Mae

Intellectual Disabilities Intermediate Care Facility · Upland, CA

NPI number 1871741082 Active

Practice location

1890 W. Arrow Route
Upland, CA 91786

Call (909) 240-7680 Map

Fax (909) 982-2991

Mailing address

1042 N. Mountain Ave, B-447
Upland, CA 91786

Specialties and licenses

TaxonomyCodeLicense
Intellectual Disabilities Intermediate Care Facility Primary 315P00000XPENDING (CA)

Intellectual Disabilities Intermediate Care Facility: An intermediate care facility providing services for individuals with intellectual disabilities.

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About NPI 1871741082

Connie Mae's National Provider Identifier is 1871741082, issued on Aug 29, 2008. The primary taxonomy on file is Intellectual Disabilities Intermediate Care Facility (315P00000X), and the practice location is in Upland, CA. The record was last updated on Aug 29, 2008.