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Organization
TEMECULA VALLEY COMPREHENSIVE TREATMENT,WHSC
Active
Organization
TEMECULA VALLEY COMPREHENSIVE TREATMENT,WHSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL R MAYNARD CAADACI (COUNSELOR)
(909) 438-0351
Entity
Organization
Contact information
Practice address
40700 CALIFORNIA OAKS RD, MURRIETA, CA 92562-5795
(951) 894-5071
Mailing address
7656 NEWBERRY LN, FONTANA, CA 92336-4250
(909) 438-0351
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
101Y00000X
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1578665790
MEDI-CAL
CA
Enumeration date
07/13/2015
Last updated
07/13/2015
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