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NPI Code Detail

MEDICARE: KIDS FIRST FOUNDATION

MEDICARE: KIDS FIRST FOUNDATION
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1322D00000XEmotionally Disturbed Childrens' Residential Treatment FacilityCA

General Provider Information

NPI Number : 1508089483
Entity Type Code : Organization
Provider Name (Legal Business Name) : KIDS FIRST FOUNDATION
Provider Business Mailing Address
First Line : 11980 MOUNT VERNON AVE
Second Line :
City : GRAND TERRACE
State : CA
Zip : 92313-5172
Country : US
Telephone Number : 909-783-8470
Fax Number : 909-783-7762
Provider Business Practice Location Address
First Line : 10001 COUNTY FARM RD
Second Line :
City : RIVERSIDE
State : CA
Zip : 92503-3507
Country : US
Telephone Number : 951-343-2536
Fax Number : 951-343-2541
Authorized Official
Title or Position : ASST. REGIONAL VP
Name : MS. JANA TREW
Credential :
Telephone Number : 909-783-8470
Provider Enumeration Date : 04/10/2007
Last Update Date : 08/22/2020

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Directions to “KIDS FIRST FOUNDATION ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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