| Merrill Community Serv Inc | |
|
9161 Sierra Ave Suite 200 Fontana CA 92335-4729 | |
| (909) 823-0609 | |
| (909) 823-4187 |
| Full Name | Merrill Community Serv Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 9161 Sierra Ave, Fontana, California |
| Authorized Official Name and Position | Warren Deavon Batiste (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9098230609 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Merrill Community Serv Inc 9161 Sierra Ave Suite 200 Fontana CA 92335-4729 Ph: (909) 823-0609 | Merrill Community Serv Inc 9161 Sierra Ave Suite 200 Fontana CA 92335-4729 Ph: (909) 823-0609 |
| NPI Number | 1962699751 |
|---|---|
| Provider Enumeration Date | 09/26/2007 |
| Last Update Date | 03/03/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962699751 | NPI | - | NPPES |
| 363648 | Other | MED I CAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 360016AN (California) | Primary |
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