Organization
IMPERIAL COUNTY COMMUNTY MENTAL HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EPIFANIA V NICOLAS DDS (PRESIDENT)
(714) 906-9116
Entity
Organization
Contact information
Practice address
708 E 5TH ST, HOLTVILLE, CA 92250-1514
(626) 991-7383
Mailing address
3218 E HOLT AVE STE 200, WEST COVINA, CA 91791-2310
(626) 991-7383
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
10/28/2019
Last updated
10/28/2019
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