# MERCY SEAT MENTAL HEALTH TREATMENT CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043920119
- **Authorized official:** STELLA ALAH-TIH FONGOD (OWNER OF THE ENTITY)
- **Authorized official phone:** (424) 221-0834

## Contact information

- **Practice address:** 1640 2ND ST STE 105, NORCO, CA 92860-2983
- **Practice address phone:** (424) 221-0834
- **Practice address fax:** (951) 407-1042
- **Mailing address:** 1640 2ND ST, NORCO, CA 92860-2969
- **Mailing address phone:** (424) 221-0834

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 11/30/2022
- **Last updated:** 04/30/2024