| I.e. Therapy Clinic | |
|
903 N Central Ave Suite A Upland CA 91786-3523 | |
| (909) 931-1600 | |
| (888) 940-8889 |
| Full Name | I.e. Therapy Clinic |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 903 N Central Ave, Upland, California |
| Authorized Official Name and Position | Liwayway Johnson (VP) |
| Authorized Official Contact | 5623037607 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| I.e. Therapy Clinic 903 N Central Ave Suite A Upland CA 91786-3523 Ph: (909) 931-1600 | I.e. Therapy Clinic 903 N Central Ave Suite A Upland CA 91786-3523 Ph: (909) 931-1600 |
| NPI Number | 1356892947 |
|---|---|
| Provider Enumeration Date | 10/18/2016 |
| Last Update Date | 10/18/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356892947 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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