Organization
BROADSCOPE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MEELYNDA RAYFORD (COO)
(951) 440-2730
Entity
Organization
Contact information
Practice address
12139 MOUNT VERNON AVE STE 101, GRAND TERRACE, CA 92313-5519
(951) 440-2730
Mailing address
12139 MOUNT VERNON AVE STE 101, GRAND TERRACE, CA 92313-5519
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
10/29/2008
Last updated
10/30/2008
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