Organization
LIDO WELLNESS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. COLLIN WEEDEN (CEO)
(949) 633-2821
Entity
Organization
Contact information
Practice address
3404 VIA LIDO, NEWPORT BEACH, CA 92663-3968
(949) 633-2821
Mailing address
3419 VIA LIDO # 313, NEWPORT BEACH, CA 92663-3908
(949) 633-2821
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
CA
Other
Enumeration date
03/09/2018
Last updated
03/09/2018
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