Organization
BOYS & GIRLS CLUBS OF GARDEN GROVE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK SURMANIAN (CHIEF EXECUTIVE OFFICER)
(714) 530-0430
Entity
Organization
Contact information
Practice address
10602 CHAPMAN AVE, GARDEN GROVE, CA 92840-3146
(714) 532-7940
Mailing address
10540 CHAPMAN AVE, GARDEN GROVE, CA 92840-3101
(714) 530-0430
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
09/05/2014
Last updated
06/16/2016
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