ETTIE LEE HOMES INC NPI 1174157960

NPI Information

  • NPI: 1174157960
  • Provider Name: ETTIE LEE HOMES, INC
  • Classification: Residential Treatment Facility, Emotionally Disturbed Children - 322D00000X
  • Entity Type: Organization
  • Doing Business As: ETTIE LEE YOUTH AND FAMILY SERVICES
  • Address: 28721 LIVE OAK CANYON RD
    REDLANDS, CA
    ZIP 92373
  • Phone: (909) 792-2137

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NPI Details

ETTIE LEE HOMES, INC is a residential treatment facility emotionally disturbed children in Redlands, CA. The provider is 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. ETTIE LEE HOMES, INC NPI is 1174157960. The provider is registered as an organization entity type.
The provider Is Doing Business As Ettie Lee Youth And Family Services.

The provider's business location address is:

28721 LIVE OAK CANYON RD
REDLANDS, CA
ZIP 92373-913
Phone: (909) 792-2137
Fax: (909) 798-0910

The provider's authorized official is Windy Luna Perez .
The authorized official title is Qa Manager and has the following contact phone number (909) 620-2521.

The enumeration date for this NPI number is 3/2/2020 and was last updated on 10/23/2024.

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:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1322D00000XResidential Treatment Facility, Emotionally Disturbed ChildrenYes

What is NPI?

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This page was last updated on: 11/21/2025

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