| Bourne Inc | |
|
2235 Lake Ave Ste 212 Altadena CA 91001-6041 | |
| (626) 797-9196 | |
| (626) 345-7790 |
| Full Name | Bourne Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2235 Lake Ave Ste 212, Altadena, California |
| Authorized Official Name and Position | Tim Tucker (CEO) |
| Authorized Official Contact | 6267861056 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bourne Inc 2235 Lake Ave Ste 212 Altadena CA 91001-6041 Ph: (626) 797-9196 | Bourne Inc 2235 Lake Ave Ste 212 Altadena CA 91001-6041 Ph: (626) 797-9196 |
| NPI Number | 1588194344 |
|---|---|
| Provider Enumeration Date | 06/14/2017 |
| Last Update Date | 03/26/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588194344 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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