Organization
CHALLENGER MEMORIAL YOUTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LISSETTE DE LEON MFT (MHCII)
(661) 940-4052
Entity
Organization
Contact information
Practice address
5300 W AVENUE I, LANCASTER, CA 93536-8312
(661) 940-4052
(661) 940-5049
Mailing address
5300 W AVENUE I, LANCASTER, CA 93536-8312
(661) 940-4052
(661) 940-5049
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
MFT 44041
CA
Other
Enumeration date
11/18/2009
Last updated
11/18/2009
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