Organization
REIMAGINE NETWORK
Active
Other names
Reimagine Network
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SOFIA CELESTINA MARTINEZ LCSW (CHIEF OF SERVICES)
(714) 680-6060
Entity
Organization
Contact information
Practice address
130 LAGUNA RD, FULLERTON, CA 92835-3614
(714) 680-6060
(714) 633-7400
Mailing address
130 LAGUNA RD, FULLERTON, CA 92835-3614
(714) 680-6060
(714) 633-7400
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
261Q00000X
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ADU70114F
—
CA
Enumeration date
02/21/2007
Last updated
04/03/2021
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