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General NPI Number Information
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NPI Number | 1790235422
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Entity Type | Organization
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Legal Business Name | ACCESS MIND INSTITUTE
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Dates
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Enumeration Date | 10/05/2016
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Last Update Date | 10/05/2016
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Provider Practice Location Address
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Address Line | 30101 TOWN CENTER DR STE 113
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City | LAGUNA NIGUEL
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State | CA
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Zip | 92677-5028
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Country | US
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Telephone | 949-257-3637
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Fax |
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Provider Business Mailing Address
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Address Line | 30101 TOWN CENTER DR STE 113
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City | LAGUNA NIGUEL
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State | CA
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Zip | 92677-5028
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Country | US
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Telephone | 949-257-3637
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. RICHARD GRANESE
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Credential | M.D.,MBA
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Telephone | 949-257-3637
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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