| Orange Tree Therapeutic Alliance, A Lcsw Corporation | |
|
11801 Pierce St Ste 200 Riverside CA 92505-4400 | |
| (951) 521-0802 | |
| Not Available |
| Full Name | Orange Tree Therapeutic Alliance, A Lcsw Corporation |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 11801 Pierce St Ste 200, Riverside, California |
| Authorized Official Name and Position | Troy Donavon Bradley (CO-FOUNDER/ PRESIDENT) |
| Authorized Official Contact | 9515210802 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Orange Tree Therapeutic Alliance, A Lcsw Corporation 11801 Pierce St Ste 200 Riverside CA 92505-4400 Ph: (951) 521-0802 | Orange Tree Therapeutic Alliance, A Lcsw Corporation 11801 Pierce St Ste 200 Riverside CA 92505-4400 Ph: (951) 521-0802 |
| NPI Number | 1144806258 |
|---|---|
| Provider Enumeration Date | 03/19/2021 |
| Last Update Date | 03/19/2021 |
| Certification Date | 03/18/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144806258 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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