Organization
EVALUATION AND TREATMENT SERVICES
Active
Parent organization
1629169222
Organization subpart
Yes
Provider details
NPI number
Legal business name
1629169222
Authorized official
A. MICHAEL P. RILLERA RN (CCN II)
(714) 834-6900
Entity
Organization
Contact information
Practice address
1030 W WARNER AVE, SANTA ANA, CA 92707-3147
(714) 834-6900
Mailing address
1030 W WARNER AVE, SANTA ANA, CA 92707-3147
(714) 834-6900
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
RN 537033
CA
Other
Enumeration date
09/27/2006
Last updated
04/23/2008
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