Organization
HILLSIDES
Active
Other names
Hillsides FRC Palmdale
Organization subpart
No
Provider details
NPI number
Authorized official
STACEY ROTH MSW (CHIEF EXECUTIVE OFFICER)
(323) 543-2800
Entity
Organization
Contact information
Practice address
1020 E PALMDALE BLVD STE 200A, PALMDALE, CA 93550-4756
(661) 678-1914
Mailing address
1020 E PALMDALE BLVD STE 200A, PALMDALE, CA 93550-4756
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
08/09/2019
Last updated
01/04/2021
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