Organization
MARYVALE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JAMIE MARIE RODRIGUEZ (LICENSED PSYCHIATRIC TECHNICIAN)
(626) 280-6510
Entity
Organization
Contact information
Practice address
7600 E. GRAVES AVE, ROSEMEAD, CA 91770-3414
(626) 280-6510
(626) 288-1026
Mailing address
7600 E. GRAVES AVE, ROSEMEAD, CA 91770-3414
(626) 280-6510
(626) 288-1026
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
PT35715
CA
Other
Enumeration date
03/08/2013
Last updated
03/08/2013
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