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1609 E Palmdale Blvd Ste G Palmdale CA 93550-4881 | |
| (661) 947-1595 | |
| (661) 575-1682 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1609 E Palmdale Blvd Ste G, Palmdale, California |
| Authorized Official Name and Position | Christina Miller (PRESIDENT AND CEO) |
| Authorized Official Contact | 5622851330 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
200 Pine Ave Ste 400 Long Beach CA 90802-3039 Ph: (562) 285-1330 | 1609 E Palmdale Blvd Ste G Palmdale CA 93550-4881 Ph: (661) 947-1595 |
| NPI Number | 1942326871 |
|---|---|
| Provider Enumeration Date | 03/22/2007 |
| Last Update Date | 10/29/2021 |
| Certification Date | 10/29/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942326871 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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