| Socal Adolescent Wellness, Inc. | |
|
22471 Aspan St Ste 110 Lake Forest CA 92630-1644 | |
| (714) 465-2305 | |
| Not Available |
| Full Name | Socal Adolescent Wellness, Inc. |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 22471 Aspan St Ste 110, Lake Forest, California |
| Authorized Official Name and Position | Rebecca M Harris (CFO) |
| Authorized Official Contact | 9494674324 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Socal Adolescent Wellness, Inc. 16168 Beach Blvd Ste 170 Huntington Beach CA 92647-3878 Ph: () - | Socal Adolescent Wellness, Inc. 22471 Aspan St Ste 110 Lake Forest CA 92630-1644 Ph: (714) 465-2305 |
| NPI Number | 1972375715 |
|---|---|
| Provider Enumeration Date | 10/25/2023 |
| Last Update Date | 10/25/2023 |
| Certification Date | 10/25/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972375715 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
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