| Cys Rite Of Passage Paragon | |
|
714 Morse Ave Placentia CA 92870-3504 | |
| (714) 572-0175 | |
| Not Available |
| Full Name | Cys Rite Of Passage Paragon |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 714 Morse Ave, Placentia, California |
| Authorized Official Name and Position | Rusty E. Alexander (BUSINESS MANAGING DIRECTOR) |
| Authorized Official Contact | 7753922639 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cys Rite Of Passage Paragon 2560 Business Pkwy Ste B Minden NV 89423-8961 Ph: (775) 392-2657 | Cys Rite Of Passage Paragon 714 Morse Ave Placentia CA 92870-3504 Ph: (714) 572-0175 |
| NPI Number | 1699250332 |
|---|---|
| Provider Enumeration Date | 09/28/2018 |
| Last Update Date | 08/05/2021 |
| Certification Date | 08/05/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699250332 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
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Jennifer Treadway-molle, Ma, Lmft, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 101 S Kraemer, Suite 230, Placentia, CA 92870 Phone: 714-402-2719 Fax: 714-993-3501 | |
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