| Immaculate Care Centr Inc. | |
|
24384 Sunnymead Blvd Ste 240 Moreno Valley CA 92553-7765 | |
| (951) 243-0303 | |
| (951) 243-3006 |
| Full Name | Immaculate Care Centr Inc. |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 24384 Sunnymead Blvd Ste 240, Moreno Valley, California |
| Authorized Official Name and Position | Japhet Okey (PROGRAM DIRECTOR) |
| Authorized Official Contact | 9512430303 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Immaculate Care Centr Inc. 24384 Sunnymead Blvd Ste 240 Moreno Valley CA 92553-7765 Ph: (951) 243-0303 | Immaculate Care Centr Inc. 24384 Sunnymead Blvd Ste 240 Moreno Valley CA 92553-7765 Ph: (951) 243-0303 |
| NPI Number | 1528195609 |
|---|---|
| Provider Enumeration Date | 02/27/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528195609 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 13102 (California) | Primary |
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