Organization
MENTAL HEALTH SUBSTANCE ABUSE
Active
Organization
MENTAL HEALTH SUBSTANCE ABUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUPE (GUADALUPE) MADRIGAL (SUPERVISOR)
(951) 737-2962
Entity
Organization
Contact information
Practice address
623 N MAIN ST STE D11, CORONA, CA 92880-1408
(951) 737-2962
(951) 737-2783
Mailing address
623 N MAIN ST STE D11, CORONA, CA 92880-1408
(951) 737-2962
(951) 737-2783
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
33023DN
CA
Other
Enumeration date
03/03/2010
Last updated
03/03/2010
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