| Logan Heights Family Counseling Center | |
|
2204 National Ave San Diego CA 92113-3615 | |
| (619) 515-2355 | |
| (619) 232-7011 |
| Full Name | Logan Heights Family Counseling Center |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 2204 National Ave, San Diego, California |
| Authorized Official Name and Position | Ricardo Roman (CFO) |
| Authorized Official Contact | 6195152300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Logan Heights Family Counseling Center 823 Gateway Center Way San Diego CA 92102-4541 Ph: (619) 515-2300 | Logan Heights Family Counseling Center 2204 National Ave San Diego CA 92113-3615 Ph: (619) 515-2355 |
| NPI Number | 1356548432 |
|---|---|
| Provider Enumeration Date | 07/02/2007 |
| Last Update Date | 02/20/2024 |
| Certification Date | 02/20/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356548432 | NPI | - | NPPES |
| FHC11890F | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 090000593 (California) | Primary |
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