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General NPI Number Information
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NPI Number | 1104542216
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Entity Type | Organization
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Legal Business Name | OPERANT SERVICES
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Dates
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Enumeration Date | 10/19/2022
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Last Update Date | 10/19/2022
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Provider Practice Location Address
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Address Line | 6529 RIVERSIDE AVE STE 230
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City | RIVERSIDE
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State | CA
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Zip | 92506-3126
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Country | US
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Telephone | 951-228-2832
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Fax | 714-333-4535
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Provider Business Mailing Address
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Address Line | PO BOX 53413
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City | IRVINE
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State | CA
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Zip | 92619-3413
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Country | US
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Telephone | 714-504-0116
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Fax | 714-333-4535
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. RAGI BOCTOR
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Credential |
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Telephone | 714-504-0116
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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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