| His House New Creation Treatment Center | |
|
239 W 9th St Upland CA 91786-5979 | |
| (909) 981-6121 | |
| (909) 912-8041 |
| Full Name | His House New Creation Treatment Center |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 239 W 9th St, Upland, California |
| Authorized Official Name and Position | Louisa Escarrzaga Gutierrez (SUPPORT STAFF) |
| Authorized Official Contact | 9517320437 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| His House New Creation Treatment Center 239 W 9th St Upland CA 91786-5979 Ph: (909) 981-6121 | His House New Creation Treatment Center 239 W 9th St Upland CA 91786-5979 Ph: (909) 981-6121 |
| NPI Number | 1376371187 |
|---|---|
| Provider Enumeration Date | 07/23/2024 |
| Last Update Date | 07/23/2024 |
| Certification Date | 07/23/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376371187 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
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