Life Source Solutions, Inc | |
4107 Mission Inn Ave Riverside CA 92501 | |
(951) 682-7143 | |
(951) 684-1135 |
Full Name | Life Source Solutions, Inc |
---|---|
Speciality | Clinic/center - Adult Mental Health |
Location | 4107 Mission Inn Ave, Riverside, California |
Authorized Official Name and Position | Avis C Attaway (OWNER) |
Authorized Official Contact | 9515229370 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Life Source Solutions, Inc Po Box 529 Riverside CA 92501 Ph: (951) 682-7143 | Life Source Solutions, Inc 4107 Mission Inn Ave Riverside CA 92501 Ph: (951) 682-7143 |
NPI Number | 1609004563 |
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Provider Enumeration Date | 06/30/2009 |
Last Update Date | 06/30/2009 |
Identifier | Type | State | Issuer |
---|---|---|---|
1609004563 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Secondary |
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