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General NPI Number Information
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NPI Number | 1194619296
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Entity Type | Organization
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Legal Business Name | ADULT WORK EXPERIENCES
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Dates
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Enumeration Date | 06/04/2025
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Last Update Date | 06/04/2025
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Provider Practice Location Address
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Address Line | 11840 MAGNOLIA AVE STE G 11840 MAGNOLIA AVE STE G
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City | RIVERSIDE
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State | CA
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Zip | 92503-9250
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Country | US
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Telephone | 951-898-5733
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Fax | 844-746-7646
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Provider Business Mailing Address
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Address Line | 11840 MAGNOLIA AVE STE G 11840 MAGNOLIA AVE STE G
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City | RIVERSIDE
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State | CA
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Zip | 92503-9250
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Country | US
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Telephone | 951-898-5733
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Fax | 844-746-7646
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | MARIE VERNON
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Credential |
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Telephone | 951-898-5733
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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