Organization
HILLSIDES
Active
Other names
Hillsides YMO Peer Resource Center
Organization subpart
No
Provider details
NPI number
Authorized official
STACEY ROTH LCSW (PRESIDENT & CEO)
(323) 543-2800
Entity
Organization
Contact information
Practice address
456 E. ORANGE GROVE BLVD, SUITE 140, PASADENA, CA 91104-5235
(626) 765-6010
(626) 765-6957
Mailing address
456 E ORANGE GROVE BLVD STE 140, PASADENA, CA 91104-5235
(626) 765-6010
(626) 765-6957
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
12/05/2018
Last updated
09/01/2021
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