Organization
BAYBREEZE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TESS BOLONG AD (ADULT CARETAKER)
(562) 432-8033
Entity
Organization
Contact information
Practice address
1653 SANTA FE AVE, LONG BEACH, CA 90813-1240
(562) 432-8033
Mailing address
1653 SANTA FE AVE, LONG BEACH, CA 90813-1240
(562) 432-8033
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
191600093
CA
Other
Enumeration date
05/07/2008
Last updated
05/07/2008
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