Organization
HILLSIDES
Active
Other names
Hillsides FRC ESGV
Organization subpart
No
Provider details
NPI number
Authorized official
STACEY ROTH LCSW (CEO)
(323) 254-2274
Entity
Organization
Contact information
Practice address
13001 RAMONA BLVD, SUITE A., IRWINDALE, CA 91706-3752
(626) 373-2900
Mailing address
13001 RAMONA BLVD, SUITE A., IRWINDALE, CA 91706-3752
(626) 373-2900
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
02/28/2013
Last updated
01/05/2021
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