Organization
MERCY SEAT MENTAL HEALTH TREATMENT CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STELLA ALAH-TIH FONGOD (OWNER OF THE ENTITY)
(424) 221-0834
Entity
Organization
Contact information
Practice address
1640 2ND ST STE 105, NORCO, CA 92860-2983
(424) 221-0834
(951) 407-1042
Mailing address
1640 2ND ST, NORCO, CA 92860-2969
(424) 221-0834
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
11/30/2022
Last updated
04/30/2024
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