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General NPI Number Information
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NPI Number | 1952538019
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Entity Type | Organization
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Legal Business Name | VINE CARE CENTER INC
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Dates
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Enumeration Date | 06/16/2009
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Last Update Date | 06/16/2009
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Provider Practice Location Address
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Address Line | 26413 JEFFERSON AVE H
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City | MURRIETA
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State | CA
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Zip | 92562-6979
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Country | US
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Telephone | 951-677-7900
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Fax | 951-677-6877
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Provider Business Mailing Address
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Address Line | 26413 JEFFERSON AVE H
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City | MURRIETA
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State | CA
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Zip | 92562-6979
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Country | US
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Telephone | 951-677-7900
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Fax | 951-677-6877
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Authorized Official
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Title or Position | DIRECTOR
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Name | NKECHI ANWULI
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Credential |
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Telephone | 951-677-7900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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