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245 North Murray Street Banning CA 92220-5528 | |
| (951) 849-8812 | |
| (951) 755-8915 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 245 North Murray Street, Banning, California |
| Authorized Official Name and Position | Sharon Heaston (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9092243942 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
245 North Murray Street Banning CA 92220-5528 Ph: (951) 849-8812 | 245 North Murray Street Banning CA 92220-5528 Ph: (951) 849-8812 |
| NPI Number | 1578893699 |
|---|---|
| Provider Enumeration Date | 01/12/2010 |
| Last Update Date | 05/25/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578893699 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 261QMO801X (California) | Primary |
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