Basic Information
| Provider Information | |||||||||
| NPI: | 1538318274 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ADS PERINATA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9941 FERON BLVD | ||||||||
| Address2: | |||||||||
| City: | RANCHO CUCAMONGA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917305270 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9512173609 | ||||||||
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| Practice Location | |||||||||
| Address1: | 850 E FOOTHILL BLVD | ||||||||
| Address2: | |||||||||
| City: | RIALTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92376 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9094219209 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/18/2008 | ||||||||
| LastUpdateDate: | 09/18/2008 | ||||||||
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| AuthorizedOfficialLastName: | ARIAS | ||||||||
| AuthorizedOfficialFirstName: | ALMA | ||||||||
| AuthorizedOfficialMiddleName: | DELIA | ||||||||
| AuthorizedOfficialTitleorPosition: | OFFICE ASSISTANT III | ||||||||
| AuthorizedOfficialTelephone: | 9512173609 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 276400000X | Y | Hospital Units | Rehabilitation, Substance Use Disorder Unit |
No ID Information.