Organization
HERITAGE BOARD & CARE #4
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRACE TRINIDAD (CONTACT PERSON)
(562) 714-2154
Entity
Organization
Contact information
Practice address
1509 E 4TH ST, LONG BEACH, CA 90802-1806
(562) 714-2154
Mailing address
2330 E 15TH ST, LONG BEACH, CA 90804-1410
(562) 714-2154
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
198600455
CA
Other
Enumeration date
06/17/2016
Last updated
06/17/2016
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