| Cys Clarvida Project Renew Fsp | |
|
1360 S Anaheim Blvd Ste 101 Anaheim CA 92805-6205 | |
| (714) 689-1380 | |
| Not Available |
| Full Name | Cys Clarvida Project Renew Fsp |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1360 S Anaheim Blvd Ste 101, Anaheim, California |
| Authorized Official Name and Position | Tracy Ginter (DIRECTOR OF STATE OPERATIONS) |
| Authorized Official Contact | 6574659497 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cys Clarvida Project Renew Fsp 8337 Telegraph Rd Ste 300 Pico Rivera CA 90660-4957 Ph: (562) 467-5440 | Cys Clarvida Project Renew Fsp 1360 S Anaheim Blvd Ste 101 Anaheim CA 92805-6205 Ph: (714) 689-1380 |
| NPI Number | 1306980974 |
|---|---|
| Provider Enumeration Date | 02/16/2007 |
| Last Update Date | 07/08/2025 |
| Certification Date | 07/08/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306980974 | NPI | - | NPPES |
| 30DI | Other | CA | OUTPATIENT BEHAVIORAL HEALTH |
| 30DI | Other | CA | MEDI-CAL PROVICER NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (NU) | Primary |
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