MY BROTHER'S KEEPER NPI 1144550971

NPI Information

MY BROTHER'S KEEPER is an addiction (substance use disorder) counselor in Chino, CA. MY BROTHER'S KEEPER NPI is 1144550971. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Serenity Outreach.

The provider's business location address is:

5511 RIVERSIDE DR
CHINO, CA
ZIP 91710-302
Phone: (909) 464-0400
Fax: (909) 464-0433

The provider's authorized official is Tanisha Williams .
The authorized official title is Cfo/ Director Of Administration and has the following contact phone number (909) 464-0400.

The CLIA number assigned to this NPI record is 05D2172282 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/29/2009 and was last updated on 12/29/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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