| Integrated Mind Institute | |
|
24949 Prospect Ave Loma Linda CA 92354-2811 | |
| (909) 796-4774 | |
| (909) 796-2774 |
| Full Name | Integrated Mind Institute |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 24949 Prospect Ave, Loma Linda, California |
| Authorized Official Name and Position | Warris Richard Walayat (CHAIRMAN) |
| Authorized Official Contact | 9097964774 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Integrated Mind Institute 24550 Lawton Ave Loma Linda CA 92354-3336 Ph: (909) 796-4774 | Integrated Mind Institute 24949 Prospect Ave Loma Linda CA 92354-2811 Ph: (909) 796-4774 |
| NPI Number | 1306072426 |
|---|---|
| Provider Enumeration Date | 06/03/2009 |
| Last Update Date | 03/12/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306072426 | NPI | - | NPPES |
| 00A970800 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | A97080 (California) | Secondary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | A97080 (California) | Primary |
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