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General NPI Number Information
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NPI Number | 1093366650
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Entity Type | Organization
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Legal Business Name | TRI-CITY MENTAL HEALTH AUTHORITY
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Dates
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Enumeration Date | 09/25/2019
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Last Update Date | 05/10/2021
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Provider Practice Location Address
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Address Line | 125 W SAN JOSE AVE
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City | CLAREMONT
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State | CA
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Zip | 91711-5205
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Country | US
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Telephone | 909-398-0316
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Fax |
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Provider Business Mailing Address
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Address Line | 1717 N INDIAN HILL BLVD STE B
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City | CLAREMONT
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State | CA
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Zip | 91711-2788
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF COMPLIANCE OFFICER
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Name | NATALIE MAJORS
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Credential |
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Telephone | 909-623-6131
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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