| Summerside Inc | |
|
180 Guava Ct Vallejo CA 94589-2321 | |
| (707) 552-7241 | |
| Not Available |
| Full Name | Summerside Inc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 180 Guava Ct, Vallejo, California |
| Authorized Official Name and Position | Edward Anderson (ADMINISTRATOR) |
| Authorized Official Contact | 7075527241 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Summerside Inc 180 Guava Ct Vallejo CA 94589-2321 Ph: () - | Summerside Inc 180 Guava Ct Vallejo CA 94589-2321 Ph: (707) 552-7241 |
| NPI Number | 1700050895 |
|---|---|
| Provider Enumeration Date | 04/18/2008 |
| Last Update Date | 04/18/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700050895 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | LTC60118F (California) | Primary |
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