Organization
PREMBO LLC
Active
Other names
SoCal Mental Health
Organization subpart
No
Provider details
NPI number
Authorized official
PRESTON JACK DURNFORD (CEO/OWNER)
(760) 409-7544
Entity
Organization
Contact information
Practice address
23711 VIA NAVARRA, MISSION VIEJO, CA 92691-3637
(760) 409-7544
Mailing address
92 CORPORATE PARK STE C-200, IRVINE, CA 92606-5146
(760) 409-7544
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
—
—
Other
Enumeration date
11/29/2021
Last updated
10/31/2022
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