Provider Demographics
NPI:1538318274
Name:ADS PERINATA
Entity Type:Organization
Organization Name:ADS PERINATA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ASSISTANT III
Authorized Official - Prefix:
Authorized Official - First Name:ALMA
Authorized Official - Middle Name:DELIA
Authorized Official - Last Name:ARIAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-217-3609
Mailing Address - Street 1:9941 FERON BLVD
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-5270
Mailing Address - Country:US
Mailing Address - Phone:951-217-3609
Mailing Address - Fax:
Practice Address - Street 1:850 E FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:RIALTO
Practice Address - State:CA
Practice Address - Zip Code:92376
Practice Address - Country:US
Practice Address - Phone:909-421-9209
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-18
Last Update Date:2008-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes276400000XHospital UnitsRehabilitation, Substance Use Disorder Unit