Healthcare Provider Details

I. General information

NPI: 1346304920
Provider Name (Legal Business Name): TRI-CITY MENTAL HEALTH AUTHORITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 09/11/2024
Certification Date: 09/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2008 N GAREY AVE
POMONA CA
91767-2722
US

IV. Provider business mailing address

2008 N GAREY AVE
POMONA CA
91767-2722
US

V. Phone/Fax

Practice location:
  • Phone: 909-623-6131
  • Fax: 909-865-9281
Mailing address:
  • Phone: 909-623-6131
  • Fax: 909-865-9281

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 Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. NATALIE MAJORS
Title or Position: DIRECTOR OF OPERATION
Credential:
Phone: 909-623-6131