| Pomona Alternative School | |
|
1460 E Holt Ave Pomona CA 91767-5856 | |
| (323) 295-1136 | |
| (323) 295-1071 |
| Full Name | Pomona Alternative School |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1460 E Holt Ave, Pomona, California |
| Authorized Official Name and Position | Josephine C Kannike-martins (CEO/EXECUTUVE DIRECTOR) |
| Authorized Official Contact | 3232951136 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pomona Alternative School 3756 Santa Rosalia Dr Ste 417 Los Angeles CA 90008-3614 Ph: (323) 295-1136 | Pomona Alternative School 1460 E Holt Ave Pomona CA 91767-5856 Ph: (323) 295-1136 |
| NPI Number | 1700225877 |
|---|---|
| Provider Enumeration Date | 06/21/2013 |
| Last Update Date | 06/21/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700225877 | NPI | - | NPPES |
| 190636AN | Other | CA | DRUG MIDICAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 190636AN (California) | Primary |
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