| |
5240 Jackson St North Highlands CA 95660-5003 | |
(916) 338-1001 | |
Not Available |
Full Name | |
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Speciality | Community/behavioral Health |
Location | 5240 Jackson St, North Highlands, California |
Authorized Official Name and Position | James Martin (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 9163381001 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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5240 Jackson St North Highlands CA 95660-5003 Ph: (916) 338-1001 | 5240 Jackson St North Highlands CA 95660-5003 Ph: (916) 338-1001 |
NPI Number | 1487988663 |
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Provider Enumeration Date | 09/22/2009 |
Last Update Date | 09/22/2009 |
Identifier | Type | State | Issuer |
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1487988663 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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251S00000X | Community/behavioral Health | LCS 001391 (California) | Primary |
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