05D2056868 CLIA NUMBER - Valley Star Tay Crisis Residential Treatment

Laboratory Demographics

CLIA Number: 05D2056868

Facility Name: Valley Star Tay Crisis Residential Treatment

Facility Address:
780 E Gilbert St
San Bernardino, CA
ZIP 92415
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Facility Phone Number: (909) 763-4760

Facility Type: OTHER

Certificate Type: Waiver

NPI Number: 1851637151

Taxonomy: 320800000X - Community Based Residential Treatment Facility, Mental Illness
A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.

CLIA Record

Field Name Field Value
CLIA Number 05D2056868
LAB Type OTHER
Facility Name Valley Star Tay Crisis Residential Treatment
Street 780 E Gilbert St
City San Bernardino
State CA
ZIP 92415
Phone (909) 763-4760

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This page was last updated on: 12/19/2019