REALITOS DIVISON is a community based residential treatment facility, intellectual and/or developmental disabilities in Montclair, CA. The provider is a home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. REALITOS DIVISON NPI is 1912159385. The provider is registered as an organization entity type.
The provider's business location address is:
9140 MONTE VISTA AVE
MONTCLAIR, CA
ZIP 91763-723
Phone: (909) 624-2774
Fax: (909) 624-6014
The provider's authorized official is Parluhutan Wahab Siregar .
The authorized official title is Qmrp/administrator and has the following contact phone number (909) 624-2774.
The CLIA number assigned to this NPI record is 05D2135654 - intermediate care facility for mentally retarded with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 10/16/2008 and was last updated on 10/16/2008.