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27200 Tourney Rd Ste 175 Santa Clarita CA 91355-4990 | |
| (661) 705-4670 | |
| (661) 964-3273 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 27200 Tourney Rd Ste 175, Santa Clarita, California |
| Authorized Official Name and Position | Leticia H Juarez (QA ADMINISTRATIVE MANAGER) |
| Authorized Official Contact | 2133420150 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
27200 Tourney Rd Ste 175 Santa Clarita CA 91355-4990 Ph: (661) 705-4670 | 27200 Tourney Rd Ste 175 Santa Clarita CA 91355-4990 Ph: (661) 705-4670 |
| NPI Number | 1205320009 |
|---|---|
| Provider Enumeration Date | 06/15/2018 |
| Last Update Date | 09/10/2024 |
| Certification Date | 09/10/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205320009 | NPI | - | NPPES |
| 00668 | Other | CA | LEGAL ENTITY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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