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Organization
PROVIDENCE COMMUNITY SERVICES
Active
Organization
PROVIDENCE COMMUNITY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINA SWANSON (INTERN)
(909) 518-1049
Entity
Organization
Contact information
Practice address
3188 AIRWAY AVE, UNIT F, COSTA MESA, CA 92626-4652
(714) 689-1380
Mailing address
1219 RUTLAND RD, NEWPORT BEACH, CA 92660-4627
(909) 518-1049
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
08/28/2011
Last updated
08/28/2011
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