| Fontana Center For Change | |
|
1076 Santo Antonio Dr Suite B & D, Rms. 2, 4, 9, & 12 Colton CA 92324-8103 | |
| (909) 357-4585 | |
| (909) 357-4589 |
| Full Name | Fontana Center For Change |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1076 Santo Antonio Dr, Colton, California |
| Authorized Official Name and Position | James C Callaghan (PRESIDENT/CEO) |
| Authorized Official Contact | 8585732600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fontana Center For Change 9465 Farnham St San Diego CA 92123-1308 Ph: (858) 573-2600 | Fontana Center For Change 1076 Santo Antonio Dr Suite B & D, Rms. 2, 4, 9, & 12 Colton CA 92324-8103 Ph: (909) 357-4585 |
| NPI Number | 1457489478 |
|---|---|
| Provider Enumeration Date | 03/01/2007 |
| Last Update Date | 08/26/2020 |
| Certification Date | 08/26/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457489478 | NPI | - | NPPES |
| 3682 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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