Organization
CSP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA DEMERJIAN (PROGRAM DIRECTOR)
(714) 492-1011
Entity
Organization
Contact information
Practice address
1221 E DYER RD, SUITE 220, SANTA ANA, CA 92705-5600
(714) 492-1011
Mailing address
1221 E DYER RD, SUITE 220, SANTA ANA, CA 92705-5600
(714) 492-1011
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
03/05/2013
Last updated
03/05/2013
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