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18623 Gale Ave Suite 154 City Of Industry CA 91748-1342 | |
| (626) 839-0300 | |
| (626) 839-1780 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 18623 Gale Ave, City Of Industry, California |
| Authorized Official Name and Position | James J. Balla (PRESIDENT & CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 6262545000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
800 S Santa Anita Ave Arcadia CA 91006-3536 Ph: (626) 254-5000 | 18623 Gale Ave Suite 154 City Of Industry CA 91748-1342 Ph: (626) 839-0300 |
| NPI Number | 1457496366 |
|---|---|
| Provider Enumeration Date | 02/20/2007 |
| Last Update Date | 09/23/2021 |
| Certification Date | 09/23/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457496366 | NPI | - | NPPES |
| 7101 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
Dynamic Recuperative Healthcare Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 17890 Castleton St Ste 309, City Of Industry, CA 91748 Phone: 626-655-1214 | |
Sin Ching Medical Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 18575 Gale Ave, Suite 288, City Of Industry, CA 91748 Phone: 626-913-0588 |