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Organization

BETHANY CHRISTIAN SERVICES OF SOUTHERN CALIFORNIA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JEFFREY PAUL CARLSON MFT (DIRECTOR)
(714) 994-0500
Entity
Organization

Contact information

Practice address
16700 VALLEY VIEW AVE, SUITE # 210, LA MIRADA, CA 90638-5830
(714) 994-0500
(714) 994-0515
Mailing address
16700 VALLEY VIEW AVE, SUITE # 210, LA MIRADA, CA 90638-5830
(714) 994-0500
(714) 994-0515

Taxonomy

Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
197804198
CA

Other

Enumeration date
08/17/2011
Last updated
08/17/2011
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