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290 Tennessee St Redlands CA 92373-1439 | |
| (909) 307-8337 | |
| (909) 307-1267 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 290 Tennessee St, Redlands, California |
| Authorized Official Name and Position | Sonia Jenny Borja (DIRECTOR OF FINANCE) |
| Authorized Official Contact | 9093357067 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 7369 Redlands CA 92375-0369 Ph: (909) 335-7067 | 290 Tennessee St Redlands CA 92373-1439 Ph: (909) 307-8337 |
| NPI Number | 1558489625 |
|---|---|
| Provider Enumeration Date | 03/27/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558489625 | NPI | - | NPPES |
| 36BQ | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (California) | Primary |
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