Organization
EQGENIX INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YVONNE HALL (CEO)
(949) 374-9522
Entity
Organization
Contact information
Practice address
254 CHAPMAN RD STE 209, NEWARK, DE 19702-5422
(888) 824-7244
Mailing address
29634 BONANZA PL, CANYON LAKE, CA 92587-7923
(949) 374-9522
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
04/08/2025
Last updated
04/08/2025
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