is a Adult Mental Health in , . practices all healthcare services and medical treatments related to Adult Mental Health. The NPI Number for is 1235348533. The last update date is .
's current location address is , , . You can contact this provider via phone number . The mailing address for is , , . To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
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| Address | , , |
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| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1235348533 |
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| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | |
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| City | |
| State | () |
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| Phone Number | |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Adult Mental Health |
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| Taxonomy | 261Qm0850X |
| Licence No | ZZZ74743Z |
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Definition: An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 360008693 | CA | MEDICAL PROVIDER NUMBER |
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