Provider First Line Business Practice Location Address:
5656 MISSION BLVD
Provider Second Line Business Practice Location Address:
JARUPA VALLEY YOUTH OPPERTUNITY CENTER
Provider Business Practice Location Address City Name:
RIVERSIDE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92509-4404
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
951-216-7312
Provider Business Practice Location Address Fax Number:
951-216-7333
Provider Enumeration Date:
03/19/2012