Organization
SOCAL THERAPLAY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMANTHA HEIDENREICH (OWNER)
(843) 267-3361
Entity
Organization
Contact information
Practice address
29595 PUJOL ST APT 1104, TEMECULA, CA 92590-6764
(951) 225-9065
Mailing address
29595 PUJOL ST APT 1104, TEMECULA, CA 92590-6764
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
09/20/2018
Last updated
09/20/2018
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