| Bella Vita Children And Family Services | |
|
31570 Railroad Canyon Rd Suite 202 Canyon Lake CA 92587-9444 | |
| (951) 757-1528 | |
| Not Available |
| Full Name | Bella Vita Children And Family Services |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 31570 Railroad Canyon Rd, Canyon Lake, California |
| Authorized Official Name and Position | Regina Rae Siez (CEO/DIRECTOR) |
| Authorized Official Contact | 9517571528 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bella Vita Children And Family Services 31570 Railroad Canyon Rd Suite 202 Canyon Lake CA 92587-9444 Ph: (951) 757-1528 | Bella Vita Children And Family Services 31570 Railroad Canyon Rd Suite 202 Canyon Lake CA 92587-9444 Ph: (951) 757-1528 |
| NPI Number | 1518305648 |
|---|---|
| Provider Enumeration Date | 06/11/2013 |
| Last Update Date | 06/11/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518305648 | NPI | - | NPPES |
| APPLIED FOR | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | LCS 25660 (California) | Primary |
Canyon Consulting Group Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 31630 Railroad Canyon Rd Ste 2a, Canyon Lake, CA 92587 Phone: 951-485-3357 |