Organization
A SECOND CHANCE
Active
Other names
California Mental Health Connection
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VAHE A HAKIMIAN ADMIN/PHARMACY TECH (ADMINISTRATOR)
(626) 430-6197
Entity
Organization
Contact information
Practice address
707 N FOXDALE AVE, WEST COVINA, CA 91790-1213
(626) 430-6197
(626) 430-7404
Mailing address
707 N FOXDALE AVE, 714 N. SUNSET AVE, WEST COVINA, CA 91790-1213
(626) 430-6197
(626) 430-7404
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
BBS4936
CA
251S00000X
Community/Behavioral Health Agency
Primary
162257
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
261Q00000X
COMMUNITY CLINIC CENTER
CA
01
—
390200000X
STUDENT IN AN ORGANIZED HEALTH CARE EDUCATION TRAINING PROGRAM
CA
01
—
390200000X
SINGLE SPECIALITY GROUP
—
01
—
AGENCY
VICITMS OF CRIME
CA
01
—
BBS4936
AGENCY
CA
Enumeration date
10/31/2011
Last updated
10/31/2011
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