Ettie Lee Homes, Inc, NPI 1992890057
Emotionally Disturbed Childrens' Residential Treatment Facility in Pomona, CA, US
NPI number: what is it?
The NPI, or National Provider Identifier, is a non-repeatable number for health care providers. The NPI always consists of 10 digits and is used for administrative and financial procedures. The NPI wa...
| NPI | 1992890057 |
| NPI Entity Type | Organization |
| Provider Name |
Ettie Lee Homes, Inc
Doing Business As |
| Enumeration Date | September 30, 2009 |
| Last Update Date | September 30, 2009 |
| Certification Date | September 30, 2009 |
| Provider Location Address | 160 E Holt Ave Ste B, Pomona, CA, US |
| Provider Mailing Address | 5146 Maine Ave, P.o. Box 339, Baldwin Park, CA, US, 917060339 |
| Gender | Male |
| Is Sole Proprietor? | No |
Organization Official
| Official Name | Kellie Marie Jarvie |
| Official Position | VICE PRESIDENT OF OPERATIONS |
| Phone | 626-383-5334 |
Primary Taxonomy
| Taxonomy Code | |
| Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility |
| Classification |
Residential Treatment Facility, Emotionally Disturbed Children |
| Group | |
| License No. | C07933 |
| License State | CA |
| Description | A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently. |
Other Identifiers
| Identifier | Identifier State | Identifier Issuer | Type/Code |
|---|---|---|---|
| 7008 | CA | DRUG & ALCOHOL | 01 |
| 7453A | CA | MENTAL HEALTH | 01 |
| 7712A | CA | MENTAL HEALTH | 01 |
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