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General NPI Number Information
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NPI Number | 1982935565
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Entity Type | Organization
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Legal Business Name | CALIFORNIA MENTAL HEALTH CONNECTION
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Dates
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Enumeration Date | 01/21/2010
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Last Update Date | 01/21/2010
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Provider Practice Location Address
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Address Line | 2217 CALLE PARRAL
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City | WEST COVINA
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State | CA
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Zip | 91792-2182
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Country | US
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Telephone | 626-430-0474
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Fax | 626-430-0474
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Provider Business Mailing Address
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Address Line | 714 N SUNSET AVE
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City | WEST COVINA
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State | CA
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Zip | 91790-1227
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Country | US
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Telephone | 626-430-0474
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Fax | 626-430-0474
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. VAHE A HAKIMIAN
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Credential | ADMINISTRATOR
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Telephone | 626-203-1449
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 198601281
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License Number State | CA
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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 | 198601281
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number | 198601281
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License Number State | CA
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