Organization
SAN DIEGO YOUTH SERVICES
Active
Other names
Bridgman Home EPSDT
Organization subpart
No
Provider details
NPI number
Authorized official
WALTER EDWIN PHILIPS LCSW (CHIEF EXECUTIVE OFFICER)
(619) 221-8600
Entity
Organization
Contact information
Practice address
968 CORTE MARIA AVE, CHULA VISTA, CA 91911-2219
(619) 651-8470
(619) 651-8467
Mailing address
3255 WING ST, SAN DIEGO, CA 92110-4638
(619) 221-8600
(619) 221-8611
Taxonomy
Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
Primary
—
—
Other
Enumeration date
03/15/2007
Last updated
04/04/2013
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