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Organization
CANYON ACRES CHILDREN AND FAMILY SERVICES
Active
Organization
CANYON ACRES CHILDREN AND FAMILY SERVICES
Active
Other names
Canyon Acres Wraparound
Organization subpart
No
Provider details
NPI number
Authorized official
FELICIA MARTIN (VICE PRESIDENT PROGRAMS)
(714) 383-9343
Entity
Organization
Contact information
Practice address
1845 W ORANGEWOOD AVE, SUITE 302, ORANGE, CA 92868-2051
(714) 383-9400
(714) 383-9243
Mailing address
1845 W ORANGEWOOD AVE, SUITE 302, ORANGE, CA 92868-2051
(714) 383-9400
(714) 383-9243
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30B2
MEDI-CAL BILLING PROVIDER
CA
Enumeration date
02/13/2007
Last updated
09/24/2009
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