| Knotts Group Home | |
|
1505 W Highland Ave Ste 19 San Bernardino CA 92411-1215 | |
| (909) 880-0600 | |
| Not Available |
| Full Name | Knotts Group Home |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1505 W Highland Ave Ste 19, San Bernardino, California |
| Authorized Official Name and Position | Joyce Forest (CLINICAL Q. A. OFFICER SOCIAL WKER) |
| Authorized Official Contact | 9098800600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Knotts Group Home 1505 W Highland Ave Ste 19 San Bernardino CA 92411-1215 Ph: (909) 880-0600 | Knotts Group Home 1505 W Highland Ave Ste 19 San Bernardino CA 92411-1215 Ph: (909) 880-0600 |
| NPI Number | 1053512970 |
|---|---|
| Provider Enumeration Date | 05/29/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053512970 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 18119386 (California) | Primary |
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