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NPI Code Detail

MEDICARE: CORRECTIONAL MENTAL HEALTH

MEDICARE: CORRECTIONAL MENTAL HEALTH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1310500000XMental Illness Intermediate Care FacilityPT31862CA

General Provider Information

NPI Number : 1245485812
Entity Type Code : Organization
Provider Name (Legal Business Name) : CORRECTIONAL MENTAL HEALTH
Provider Business Mailing Address
First Line : 501 THE CITY DR S
Second Line :
City : ORANGE
State : CA
Zip : 92868-3305
Country : US
Telephone Number : 714-935-6091
Fax Number : 714-935-6196
Provider Business Practice Location Address
First Line : 501 THE CITY DR S
Second Line :
City : ORANGE
State : CA
Zip : 92868-3305
Country : US
Telephone Number : 714-935-6091
Fax Number : 714-935-6196
Authorized Official
Title or Position : MENTAL HEALTH SPECIALIST
Name : MS. ROSANGELA QUIROZ
Credential : LPT
Telephone Number : 714-935-6091
Provider Enumeration Date : 11/24/2008
Last Update Date : 11/24/2008

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Directions to “CORRECTIONAL MENTAL HEALTH ” Practice Location

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