| Personalized Treatment & Intervention Services | |
|
519 E Hazel St Unit 17 Inglewood CA 90302-5358 | |
| (916) 904-4607 | |
| Not Available |
| Full Name | Personalized Treatment & Intervention Services |
|---|---|
| Speciality | Clinic/Center |
| Location | 519 E Hazel St Unit 17, Inglewood, California |
| Authorized Official Name and Position | Earnestine Whitson (DIRECTOR) |
| Authorized Official Contact | 3233795003 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Personalized Treatment & Intervention Services 519 E Hazel St Unit 17 Inglewood CA 90302-5358 Ph: (916) 904-4607 | Personalized Treatment & Intervention Services 519 E Hazel St Unit 17 Inglewood CA 90302-5358 Ph: (916) 904-4607 |
| NPI Number | 1861026445 |
|---|---|
| Provider Enumeration Date | 02/23/2020 |
| Last Update Date | 06/11/2020 |
| Certification Date | 06/11/2020 |
| Medicare PECOS PAC ID | 2860815099 |
|---|---|
| Medicare Enrollment ID | O20240223003766 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861026445 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Carmon Nacole Williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124449426 PECOS PAC ID: 0648622894 Enrollment ID: I20240123004202 |
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