| Cys Youth Reporting Center North | |
|
1920 W Corporate Way Anaheim CA 92801-5373 | |
| (714) 667-7610 | |
| (714) 667-7621 |
| Full Name | Cys Youth Reporting Center North |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 1920 W Corporate Way, Anaheim, California |
| Authorized Official Name and Position | Kelly Kathleen Sabet (CHIEF COMPLIANCE OFFICER) |
| Authorized Official Contact | 7145817769 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cys Youth Reporting Center North 405 W 5th St Ste 212 Santa Ana CA 92701-4522 Ph: (714) 568-5614 | Cys Youth Reporting Center North 1920 W Corporate Way Anaheim CA 92801-5373 Ph: (714) 667-7610 |
| NPI Number | 1407993249 |
|---|---|
| Provider Enumeration Date | 01/31/2007 |
| Last Update Date | 09/06/2023 |
| Certification Date | 09/06/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407993249 | NPI | - | NPPES |
| 30BK | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
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