Organization
SOUTH BAY COMMUNITY SERVICES
Active
Parent organization
SOUTH BAY COMMUNITY SERVICES
Other names
CAT - EPSDT
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTH BAY COMMUNITY SERVICES
Authorized official
KATHRYN LEMBO BA (EXECUTIVE DIRECTOR)
(619) 420-3620
Entity
Organization
Contact information
Practice address
430 F ST, CHULA VISTA, CA 91910-3711
(619) 420-3620
(619) 420-8722
Mailing address
430 F ST, CHULA VISTA, CA 91910-3711
(619) 420-3620
(619) 420-8722
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37GA
DMH
CA
Enumeration date
01/19/2007
Last updated
08/02/2012
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