Organization · NPI-2

Harvest Safe Haven For Boys

Residential Treatment Facility, Emotionally Disturbed Children · Riverside, CA

NPI number1174132807
StatusActive
Last updated in NPPESJul 28, 2020

Details

NPI
1174132807
Entity type
Organization (NPI-2)
Legal business name
Harvest Safe Haven For Boys
Organization subpart
No
Enumeration date
Jul 28, 2020
Certification date
Jul 28, 2020
Last updated
Jul 28, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
322D00000X Residential Treatment Facility, Emotionally Disturbed Children––Yes

Practice location

5425 Sierra Vista Ave
Riverside, CA 92505-3113

Phone 951-715-3126 · Fax 951-531-8605

Mailing address

3380 La Sierra Ave Ste 104-242
Riverside, CA 92503-5271

Phone 951-715-3126 · Fax 951-531-8605

Authorized official

Daniel Park
Executive Director
9512958239

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