| Hillsides Frc Pomona | |
|
1902 Royalty Drive Suite 240 & 260 Pomona CA 91767-3061 | |
| (909) 622-3200 | |
| (323) 978-1263 |
| Full Name | Hillsides Frc Pomona |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1902 Royalty Drive Suite 240 & 260, Pomona, California |
| Authorized Official Name and Position | Stacey Roth (CEO) |
| Authorized Official Contact | 3235432800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hillsides Frc Pomona 1902 Royalty Drive Suite 240 & 260 Pomona CA 91767-3061 Ph: (909) 622-3200 | Hillsides Frc Pomona 1902 Royalty Drive Suite 240 & 260 Pomona CA 91767-3061 Ph: (909) 622-3200 |
| NPI Number | 1700270188 |
|---|---|
| Provider Enumeration Date | 03/24/2015 |
| Last Update Date | 08/31/2022 |
| Certification Date | 08/31/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700270188 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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