Main Street Hesperia Center | |
14628 Main Street Hesperia CA 92345 | |
(909) 382-3080 | |
(909) 382-3105 |
Full Name | Main Street Hesperia Center |
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Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
Location | 14628 Main Street, Hesperia, California |
Authorized Official Name and Position | Michael J Day (INFORMATION TECHNOLOGY MANAGER) |
Authorized Official Contact | 9093880570 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Main Street Hesperia Center 268 W Hospitality Lane Suite 400 San Bernardino CA 92415-0026 Ph: (909) 382-3080 | Main Street Hesperia Center 14628 Main Street Hesperia CA 92345 Ph: (909) 382-3080 |
NPI Number | 1154539765 |
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Provider Enumeration Date | 05/18/2007 |
Last Update Date | 09/24/2009 |
Identifier | Type | State | Issuer |
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1154539765 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | ZZZ74743Z (California) | Primary |
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