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NPI 1497369987

NPI 1497369987 : CROWNVIEW TELEHEALTH INSTIUTE LLC : OCEANSIDE, CA

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General NPI Number Information
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    NPI Number           |    1497369987
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    Entity Type          |    Organization 
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    Legal Business Name  |    CROWNVIEW TELEHEALTH INSTIUTE LLC 
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Dates
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    Enumeration Date     |    09/02/2020
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    Last Update Date     |    09/02/2020
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Provider Practice Location Address
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    Address Line         |    315 NORTH CLEMENTINE STREET 
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    City                 |    OCEANSIDE
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    State                |    CA
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    Zip                  |    92054
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    Country              |    US
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    Telephone            |    760-231-5820
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    Fax                  |    760-279-8672
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Provider Business Mailing Address
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    Address Line         |    315 NORTH CLEMENTINE STREET 
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    City                 |    OCEANSIDE
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    State                |    CA
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    Zip                  |    92054
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    Country              |    US
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    Telephone            |    760-231-5820
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    Fax                  |    760-279-8672
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Authorized Official
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    Title or Position    |    OFFICE ADMINISTRATOR
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    Name                 |     STACY LYNN MORRIS 
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    Credential           |    
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    Telephone            |    760-231-5820
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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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