| Ssg Project 180 North | |
|
1050 E Palmdale Blvd Suite 211 Palmdale CA 93550-4750 | |
| (213) 620-5712 | |
| Not Available |
| Full Name | Ssg Project 180 North |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1050 E Palmdale Blvd, Palmdale, California |
| Authorized Official Name and Position | Herbert K Hatanaka (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2135531800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ssg Project 180 North 905 E 8th St Los Angeles CA 90021-1848 Ph: (213) 553-1800 | Ssg Project 180 North 1050 E Palmdale Blvd Suite 211 Palmdale CA 93550-4750 Ph: (213) 620-5712 |
| NPI Number | 1568892495 |
|---|---|
| Provider Enumeration Date | 11/13/2013 |
| Last Update Date | 11/23/2021 |
| Certification Date | 11/23/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568892495 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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