| |
715 N Central Ave Suite 108 Glendale CA 91203-4262 | |
(818) 660-5307 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Adolescent And Children Mental Health |
Location | 715 N Central Ave, Glendale, California |
Authorized Official Name and Position | Rachel Facio (OWNER & PRESIDENT) |
Authorized Official Contact | 8184001321 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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7035 Whitaker Ave Lake Balboa CA 91406-3718 Ph: (818) 660-5307 | 715 N Central Ave Suite 108 Glendale CA 91203-4262 Ph: (818) 660-5307 |
NPI Number | 1902338015 |
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Provider Enumeration Date | 03/28/2017 |
Last Update Date | 03/28/2017 |
Identifier | Type | State | Issuer |
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1902338015 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM0855X | Clinic/center - Adolescent And Children Mental Health | 97351 (California) | Primary |
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