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Organization
IMMACULATE CARE CENTR INC.
Active
Organization
IMMACULATE CARE CENTR INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAPHET OKEY (PROGRAM DIRECTOR)
(951) 243-0303
Entity
Organization
Contact information
Practice address
24384 SUNNYMEAD BLVD STE 240, MORENO VALLEY, CA 92553-7765
(951) 243-0303
(951) 243-3006
Mailing address
24384 SUNNYMEAD BLVD STE 240, MORENO VALLEY, CA 92553-7765
(951) 243-0303
(951) 243-3006
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
13102
CA
Other
Enumeration date
02/27/2007
Last updated
08/22/2020
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