OrganizationActive
Acts for Children
NPI 1780888685 · Emotionally Disturbed Childrens' Residential Treatment Facility · Bloomington, CA
Provider details
- NPI number
- 1780888685
- Entity type
- Organization
- Primary specialty
- Emotionally Disturbed Childrens' Residential Treatment FacilityResidential Treatment Facilities
- Authorized official
- Ike Kerhulas, Campus Director
Practice location
18136 Jurupa Ave
Bloomington, CA 92316-3009
Phone: (909) 877-5499
Fax: (909) 877-1343
Mailing address
18136 Jurupa Ave
Bloomington, CA 92316-3009
Registry dates
- Enumerated
- 2007-06-13
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.