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Erica Rene Graham-bullock
Intellectual and/or Developmental Disabilities Residential Treatment Facility in Perris, California
NPI 1063284875

Erica Rene Graham-bullock is a Intellectual and/or Developmental Disabilities Residential Treatment Facility based in Perris, CA. Erica Rene Graham-bullock practices in Perris, CA. The NPI Number for Erica Rene Graham-bullock is 1063284875 and holds a License No. 331881331 (California).

The current practice location address for Erica Rene Graham-bullock is 3656 Ginger St, Perris, CA and can be reached out via phone at 818-818-1817.

Location: 3656 Ginger St, Perris, CA, 92571-7825
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1063284875
Provider Name
Erica Rene Graham-bullock
Credential
Provider Entity Type
Individual
Gender
Female
Address
3656 Ginger St, Perris, CA, 92571-7825
Phone Number
818-818-1817
Fax Number
Provider Enumeration Date
10/25/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
3656 Ginger St
City
Perris
State
California
Zip
92571-7825
Phone Number
818-818-1817
Fax Number
person
Provider Business Mailing Address Details
Address
3656 Ginger St
City
Perris
State
California
Zip
92571-7825
Phone Number
818-818-1817
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320600000X
License No.
331881331 (California)
Definition
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.
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