| Providence Community Services | |
|
3188 Airway Ave Unit F Costa Mesa CA 92626-4652 | |
| (714) 689-1380 | |
| Not Available |
| Full Name | Providence Community Services |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 3188 Airway Ave, Costa Mesa, California |
| Authorized Official Name and Position | Christina Swanson (INTERN) |
| Authorized Official Contact | 9095181049 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Community Services 1219 Rutland Rd Newport Beach CA 92660-4627 Ph: (909) 518-1049 | Providence Community Services 3188 Airway Ave Unit F Costa Mesa CA 92626-4652 Ph: (714) 689-1380 |
| NPI Number | 1366722852 |
|---|---|
| Provider Enumeration Date | 08/28/2011 |
| Last Update Date | 08/28/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366722852 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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