| Locked In Cea Inc. | |
|
4937 Sierra Vista Ave Riverside CA 92505 | |
| (951) 394-1656 | |
| Not Available |
| Full Name | Locked In Cea Inc. |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 4937 Sierra Vista Ave, Riverside, California |
| Authorized Official Name and Position | Deanne M Knipschild (CEO) |
| Authorized Official Contact | 9513941656 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Locked In Cea Inc. P.o. Box 70665 Riverside CA 92513 Ph: (951) 394-1656 | Locked In Cea Inc. 4937 Sierra Vista Ave Riverside CA 92505 Ph: (951) 394-1656 |
| NPI Number | 1063101715 |
|---|---|
| Provider Enumeration Date | 05/08/2023 |
| Last Update Date | 05/08/2023 |
| Certification Date | 05/07/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063101715 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
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