| Fifth Avenue Behavioral Health Center | |
|
1750 5th Ave San Diego CA 92101-2754 | |
| (619) 515-2588 | |
| (619) 450-6267 |
| Full Name | Fifth Avenue Behavioral Health Center |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 1750 5th Ave, San Diego, California |
| Authorized Official Name and Position | Ricardo Roman (CFO) |
| Authorized Official Contact | 6199064603 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fifth Avenue Behavioral Health Center 823 Gateway Center Way San Diego CA 92102-4541 Ph: (619) 515-2300 | Fifth Avenue Behavioral Health Center 1750 5th Ave San Diego CA 92101-2754 Ph: (619) 515-2588 |
| NPI Number | 1538590781 |
|---|---|
| Provider Enumeration Date | 12/12/2013 |
| Last Update Date | 02/20/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538590781 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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