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10417 Main St Lamont CA 93241-1338 | |
| (661) 845-5100 | |
| (661) 845-5106 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 10417 Main St, Lamont, California |
| Authorized Official Name and Position | Olga Meave (CEO) |
| Authorized Official Contact | 6616353050 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 1559 Bakersfield CA 93302-1559 Ph: (661) 635-3050 | 10417 Main St Lamont CA 93241-1338 Ph: (661) 845-5100 |
| NPI Number | 1417177460 |
|---|---|
| Provider Enumeration Date | 05/01/2007 |
| Last Update Date | 02/09/2024 |
| Certification Date | 09/07/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417177460 | NPI | - | NPPES |
| 1571 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |