Organization
LOC DO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATIE WELLS (PROGRAM DIRECTOR)
(714) 901-4629
Entity
Organization
Contact information
Practice address
13950 MILTON AVE, SUITE 303, WESTMINSTER, CA 92683-2900
(714) 901-4629
Mailing address
2632 E DENISE AVE, ORANGE, CA 92867-1816
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
10/13/2009
Last updated
10/26/2009
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