Organization
CANYON ACRES CHILDREN AND FAMILY SERVICES
Active
Other names
Canyon Acres Wraparound
Organization subpart
No
Provider details
NPI number
Authorized official
FELICIA MARTIN (VICE PRESIDENT PROGRAMS)
(714) 383-9343
Entity
Organization
Contact information
Practice address
1845 W ORANGEWOOD AVE, SUITE 302, ORANGE, CA 92868-2051
(714) 383-9400
(714) 383-9243
Mailing address
1845 W ORANGEWOOD AVE, SUITE 302, ORANGE, CA 92868-2051
(714) 383-9400
(714) 383-9243
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30B2
MEDI-CAL BILLING PROVIDER
CA
Enumeration date
02/13/2007
Last updated
09/24/2009
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