Healthcare Provider Details

I. General information

NPI: 1194114959
Provider Name (Legal Business Name): PRIME PERFORMANCE HEALTH D.B.A. HITTING THE RIGHT NOTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2015
Last Update Date: 01/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 N CENTRAL AVE
COMPTON CA
90222-1640
US

IV. Provider business mailing address

1218 E BROADWAY SUITE 307
LONG BEACH CA
90802-3639
US

V. Phone/Fax

Practice location:
  • Phone: 562-230-0960
  • Fax:
Mailing address:
  • Phone: 562-230-0960
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. ANGELA MCAFEE
Title or Position: PRESIDENT
Credential:
Phone: 562-230-0960