OrganizationActive
Shady Glen Facility
NPI 1003046566 · Developmental Disabilities Clinic/Center · San Bernardino, CA
Provider details
- NPI number
- 1003046566
- Entity type
- Organization
- Primary specialty
- Developmental Disabilities Clinic/CenterAmbulatory Health Care Facilities
- Parent organization
- Bridges in Communications, Inc
- Authorized official
- Patricia Stone, Administrator
- License
- 360911227 (CA)
Practice location
2571 Shady Glen Ln
San Bernardino, CA 92408-4174
Phone: (909) 783-8806
Mailing address
2571 Shady Glen Ln
San Bernardino, CA 92408-4174
Registry dates
- Enumerated
- 2009-07-19
- Last updated
- 2009-07-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.