WANDA NPI 1538322656

NPI Information

WANDA is a residential treatment facility physical disabilities in Rialto, CA. The provider is a residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with physical disabilities and are not able to live independently. WANDA NPI is 1538322656. The provider is registered as an organization entity type.

The provider's business location address is:

3730 FERNWOOD AVE
RIALTO, CA
ZIP 92377-724
Phone: (909) 823-3703
Fax: (909) 823-3703

The provider's authorized official is Wanda Jean Smith .
The authorized official title is Lvn and has the following contact phone number (909) 496-2440.

The enumeration date for this NPI number is 7/9/2008 and was last updated on 9/6/2023.

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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