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324 N Park Ave Pomona CA 91768-3839 | |
| (909) 397-4200 | |
| (909) 397-4227 |
| Full Name | |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 324 N Park Ave, Pomona, California |
| Authorized Official Name and Position | Betty Amiohi Uwadia Ajoku (CEO) |
| Authorized Official Contact | 9093974200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
324 N Park Ave Po Box 331 Pomona CA 91768-3839 Ph: (909) 397-4200 | 324 N Park Ave Pomona CA 91768-3839 Ph: (909) 397-4200 |
| NPI Number | 1700054681 |
|---|---|
| Provider Enumeration Date | 02/13/2008 |
| Last Update Date | 02/13/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700054681 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
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