ETTIE LEE HOMES INC NPI 1992890057

NPI Information

NPI: 1992890057
Provider Name: ETTIE LEE HOMES, INC
Classification: Clinic/Center - 261QM0855X
Specialization: Adolescent and Children Mental Health
Entity Type: Organization
Doing Business As: ETTIE LEE HOMES POMONA
Address: 160 E HOLT AVE STE B
POMONA, CA
ZIP 91767
Phone: (909) 620-2521

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NPI Details

ETTIE LEE HOMES, INC is an adolescent and children mental health clinic center in Pomona, CA. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. ETTIE LEE HOMES, INC NPI is 1992890057. The provider is registered as an organization entity type.
The provider Is Doing Business As Ettie Lee Homes Pomona.

The provider's business location address is:

160 E HOLT AVE STE B
POMONA, CA
ZIP 91767-407
Phone: (909) 620-2521
Fax: (909) 620-9793

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 10/4/2006 and was last updated on 10/24/2024.

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
1	253J00000X	Foster Care Agency				No
2	261QM0855X	Clinic/Center	Adolescent and Children Mental Health			Yes
3	322D00000X	Residential Treatment Facility, Emotionally Disturbed Children		C07933	CALIFORNIA	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	36IHCR	OTHER	CALIFORNIA	SBCDBH
2	7453A	OTHER	CALIFORNIA	LACDMH

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

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

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