Organization
SHAHIDA K SYED ENTERPRISES LLC
Active
Other names
Shahida's Place
Organization subpart
No
Provider details
NPI number
Authorized official
ABBY BOYD (BILLING DIRECTOR)
(772) 353-1410
Entity
Organization
Contact information
Practice address
19660 ARCADIA ST, CORONA, CA 92881-4302
(909) 367-6818
Mailing address
19660 ARCADIA ST, CORONA, CA 92881-4302
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
330179BP
STATE LICENSE
CA
01
—
330179CP
STATE LICENSE
CA
Enumeration date
12/14/2020
Last updated
12/03/2024
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