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General NPI Number Information
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NPI Number | 1790078244
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Entity Type | Organization
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Legal Business Name | BETTY G. GIBBEL REGIONAL LEARNING CENTER
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Dates
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Enumeration Date | 05/17/2011
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Last Update Date | 05/17/2011
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Provider Practice Location Address
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Address Line | 1251 EAGLE RD
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City | SAN JACINTO
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State | CA
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Zip | 92583-2754
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Country | US
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Telephone | 951-683-6596
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Fax |
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Provider Business Mailing Address
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Address Line | 5870 ARLINGTON AVE
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City | RIVERSIDE
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State | CA
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Zip | 92504-2037
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Country | US
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Telephone | 951-683-6596
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | CRAIG LAMBDIN
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Credential |
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Telephone | 951-683-6596
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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