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2050 Bonita Ave Ste C La Verne CA 91750-4441 | |
| (909) 957-9763 | |
| (909) 575-3641 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2050 Bonita Ave, La Verne, California |
| Authorized Official Name and Position | Lori A Switanowski (OWNER) |
| Authorized Official Contact | 9098513261 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2050 Bonita Ave Ste C La Verne CA 91750-4441 Ph: (909) 957-9763 | 2050 Bonita Ave Ste C La Verne CA 91750-4441 Ph: (909) 957-9763 |
| NPI Number | 1831457761 |
|---|---|
| Provider Enumeration Date | 04/28/2012 |
| Last Update Date | 05/06/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831457761 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | MFC25879 (California) | Primary |
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