| Madeline C Douglas | |
|
1255 W Colton Ave Redlands CA 92374-2861 | |
| (909) 363-4661 | |
| (909) 495-1634 |
| Full Name | Madeline C Douglas |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1255 W Colton Ave, Redlands, California |
| Authorized Official Name and Position | Madeline C Douglas (OWNER) |
| Authorized Official Contact | 2176074215 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Madeline C Douglas Po Box 1023 San Bernardino CA 92402-1023 Ph: (217) 607-4215 | Madeline C Douglas 1255 W Colton Ave Redlands CA 92374-2861 Ph: (909) 363-4661 |
| NPI Number | 1992551691 |
|---|---|
| Provider Enumeration Date | 04/24/2024 |
| Last Update Date | 04/24/2024 |
| Certification Date | 04/24/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992551691 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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