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Connie Mae
Intellectual Disabilities Intermediate Care Facility in Upland, California
NPI 1871741082

Connie Mae is a Intellectual Disabilities Intermediate Care Facility based in Upland, CA. Connie Mae practices in Upland, CA. The NPI Number for Connie Mae is 1871741082 and holds a License No. PENDING (California).

The current practice location address for Connie Mae is 1890 W. Arrow Route, Upland, CA and can be reached out via phone at 909-240-7680 and via fax at 909-982-2991.

Location: 1890 W. Arrow Route, Upland, CA, 91786
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1871741082
Provider Name
Connie Mae
Credential
Provider Entity Type
Organization
Address
1890 W. Arrow Route, Upland, CA, 91786
Phone Number
909-240-7680
Fax Number
909-982-2991
Provider Enumeration Date
08/29/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
PENDING 05 CA
institution
Provider Business Practice Location Address Details
Address
1890 W. Arrow Route
City
Upland
State
California
Zip
91786
Phone Number
909-240-7680
Fax Number
909-982-2991
person
Provider Business Mailing Address Details
Address
1890 W. Arrow Route
City
Upland
State
California
Zip
91786
Phone Number
909-240-7680
Fax Number
909-982-2991
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Intermediate Care Facility, Mentally Retarded
Speciality
-
Taxonomy
315P00000X
License No.
PENDING (California)
Definition
(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals.
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