| Cys Rite Of Passage Johnson | |
|
3068 Johnson Ave Costa Mesa CA 92626-2819 | |
| (714) 454-7144 | |
| Not Available |
| Full Name | Cys Rite Of Passage Johnson |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 3068 Johnson Ave, Costa Mesa, California |
| Authorized Official Name and Position | Nancey Carter (BEHAVIORAL HEALTH COMPLIANCE DIR) |
| Authorized Official Contact | 4809872053 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cys Rite Of Passage Johnson 2560 Business Pkwy Ste B Minden NV 89423-8961 Ph: (480) 987-2053 | Cys Rite Of Passage Johnson 3068 Johnson Ave Costa Mesa CA 92626-2819 Ph: (714) 454-7144 |
| NPI Number | 1497437040 |
|---|---|
| Provider Enumeration Date | 08/03/2023 |
| Last Update Date | 11/03/2023 |
| Certification Date | 11/03/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497437040 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
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