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10420 Main St Lamont CA 93241-1727 | |
(661) 845-3753 | |
(661) 845-4866 |
Full Name | |
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Speciality | Community/behavioral Health |
Location | 10420 Main St, Lamont, California |
Authorized Official Name and Position | Dwayne Anthony Gotay (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 6618453753 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 3067 Bakersfield CA 93385 Ph: (661) 845-3753 | 10420 Main St Lamont CA 93241-1727 Ph: (661) 845-3753 |
NPI Number | 1053524405 |
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Provider Enumeration Date | 05/08/2007 |
Last Update Date | 10/28/2014 |
Identifier | Type | State | Issuer |
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1053524405 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |