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Organization

FLORENCE CRITTENTON SERVICES OF ORANGE COUNTY, INC.

Active
Other names
CRITTENTON SERVICES FOR CHILDREN & FAMILIES
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MANFRED FRITZ CZYPULL MIM (CEO)
(714) 680-8268
Entity
Organization

Contact information

Practice address
801 E CHAPMAN AVE, SUITE 220, FULLERTON, CA 92831-3839
(714) 680-8268
(714) 680-8207
Mailing address
801 E CHAPMAN AVE, SUITE 203, FULLERTON, CA 92831-3839
(714) 680-8268
(714) 680-8207

Taxonomy

Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
300612972
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00870
MH LEGAL ENTITY
CA
01
300600336
DSS FACILITY LICENSE
CA
01
300612972
DSS FACILITY LICENSE
CA
01
306099612
DSS FACILITY LICENSE
CA
01
7518
MEDICAL CERTIFICATION C.
CA
01
7523
MEDICAL CERTIFICATION H
CA
01
7524
MEDICAL CERTIFICATION VV
CA
01
7554
MEDICAL CERTIFICATION B
CA
01
7605
MEDICAL CERTIFICATION LB
CA
Enumeration date
09/28/2006
Last updated
05/16/2014
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