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1002 E Grand Ave Escondido CA 92025-4605 | |
| (760) 741-2660 | |
| (760) 741-2647 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1002 E Grand Ave, Escondido, California |
| Authorized Official Name and Position | Lisa Turner (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7607412660 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1002 E Grand Ave Escondido CA 92025-4605 Ph: (760) 741-2660 | 1002 E Grand Ave Escondido CA 92025-4605 Ph: (760) 741-2660 |
| NPI Number | 1063613024 |
|---|---|
| Provider Enumeration Date | 05/29/2007 |
| Last Update Date | 10/01/2024 |
| Certification Date | 10/01/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063613024 | NPI | - | NPPES |
| 37H8 | Other | CA | MEDI-CAL PROVIDER NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (California) | Primary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
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