| Roybal School Based Program | |
|
215 E Avenida De La Merced # 103 Montebello CA 90640-2752 | |
| (323) 887-5324 | |
| (323) 887-5801 |
| Full Name | Roybal School Based Program |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 215 E Avenida De La Merced # 103, Montebello, California |
| Authorized Official Name and Position | Lisa H. Wong (ACTING DIRECTOR) |
| Authorized Official Contact | 2137384601 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Roybal School Based Program 510 S Vermont Ave Los Angeles CA 90020-1992 Ph: (213) 738-4601 | Roybal School Based Program 215 E Avenida De La Merced # 103 Montebello CA 90640-2752 Ph: (323) 887-5324 |
| NPI Number | 1871507129 |
|---|---|
| Provider Enumeration Date | 07/29/2006 |
| Last Update Date | 03/23/2023 |
| Certification Date | 03/23/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871507129 | NPI | - | NPPES |
| 7584 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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