| |
6083 Maxwell Dr Paradise CA 95969-4025 | |
(530) 762-1811 | |
(530) 894-5791 |
Full Name | |
---|---|
Speciality | Clinic/center - Adolescent And Children Mental Health |
Location | 6083 Maxwell Dr, Paradise, California |
Authorized Official Name and Position | Rosemary Lisa Kelly (AUTHORIZED OFFICIAL) |
Authorized Official Contact | 5308945933 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
6083 Maxwell Dr Paradise CA 95969-4025 Ph: (530) 762-1811 | 6083 Maxwell Dr Paradise CA 95969-4025 Ph: (530) 762-1811 |
NPI Number | 1013453802 |
---|---|
Provider Enumeration Date | 01/17/2017 |
Last Update Date | 07/21/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1013453802 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |