| Step Up On Second Street, Inc. | |
|
3314 W 1st St Ste B Santa Ana CA 92703-5449 | |
| (714) 296-9361 | |
| Not Available |
| Full Name | Step Up On Second Street, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 3314 W 1st St Ste B, Santa Ana, California |
| Authorized Official Name and Position | David Mark Tavlin (CHIEF PROGRAM OFFICE) |
| Authorized Official Contact | 3109855250 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Step Up On Second Street, Inc. 3314 W 1st St Ste B Santa Ana CA 92703-5449 Ph: (714) 296-9361 | Step Up On Second Street, Inc. 3314 W 1st St Ste B Santa Ana CA 92703-5449 Ph: (714) 296-9361 |
| NPI Number | 1255195996 |
|---|---|
| Provider Enumeration Date | 02/13/2024 |
| Last Update Date | 02/13/2024 |
| Certification Date | 02/13/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255195996 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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