Healthcare Provider Details

I. General information

NPI: 1225331416
Provider Name (Legal Business Name): MFI TEMESCAL CANYON HIGH SCHOOL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2010
Last Update Date: 12/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28755 EL TORO RD
LAKE ELSINORE CA
92532-1912
US

IV. Provider business mailing address

5870 ARLINGTON AVE
RIVERSIDE CA
92504-2037
US

V. Phone/Fax

Practice location:
  • Phone: 951-698-8558
  • Fax:
Mailing address:
  • Phone: 951-698-8558
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: LORENA RAMIREZ
Title or Position: MANAGER
Credential:
Phone: 951-698-8558