| Adom Telepsychiatry And Mental Health Services A Professional Nur | |
|
4199 Flat Rock Dr Ste 148 Riverside CA 92505-7115 | |
| (951) 707-7471 | |
| Not Available |
| Full Name | Adom Telepsychiatry And Mental Health Services A Professional Nur |
|---|---|
| Speciality | Clinic/Center |
| Location | 4199 Flat Rock Dr Ste 148, Riverside, California |
| Authorized Official Name and Position | Gladys Obeng (DNP) |
| Authorized Official Contact | 9517077471 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Adom Telepsychiatry And Mental Health Services A Professional Nur Po Box 77331 Corona CA 92877-0111 Ph: (951) 254-3558 | Adom Telepsychiatry And Mental Health Services A Professional Nur 4199 Flat Rock Dr Ste 148 Riverside CA 92505-7115 Ph: (951) 707-7471 |
| NPI Number | 1003407388 |
|---|---|
| Provider Enumeration Date | 01/29/2021 |
| Last Update Date | 01/10/2023 |
| Certification Date | 01/10/2023 |
| Medicare PECOS PAC ID | 9234511882 |
|---|---|
| Medicare Enrollment ID | O20220729001082 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003407388 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Gladys K Obeng |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356559553 PECOS PAC ID: 8224362553 Enrollment ID: I20220729002127 |
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