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1035 W Ramsey St Ste B4 Banning CA 92220-4400 | |
| (951) 849-0400 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1035 W Ramsey St Ste B4, Banning, California |
| Authorized Official Name and Position | Helena Lopez (CEO) |
| Authorized Official Contact | 7602560432 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 1477 Victorville CA 92393-1477 Ph: (760) 243-3999 | 1035 W Ramsey St Ste B4 Banning CA 92220-4400 Ph: (951) 849-0400 |
| NPI Number | 1346709409 |
|---|---|
| Provider Enumeration Date | 03/18/2019 |
| Last Update Date | 08/08/2024 |
| Certification Date | 08/08/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346709409 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| 253J00000X | Foster Care Agency | (* (Not Available)) | Secondary |
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