| Innroads - West Valley | |
|
9445 Fairway View Pl Ste 110 Rancho Cucamonga CA 91730-0930 | |
| (909) 948-6200 | |
| Not Available |
| Full Name | Innroads - West Valley |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 9445 Fairway View Pl Ste 110, Rancho Cucamonga, California |
| Authorized Official Name and Position | Erica Porteous (CHIEF COMPLIANCE OFFICER) |
| Authorized Official Contact | 9093880879 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Innroads - West Valley 303 E Vanderbilt Way San Bernardino CA 92415-0026 Ph: () - | Innroads - West Valley 9445 Fairway View Pl Ste 110 Rancho Cucamonga CA 91730-0930 Ph: (909) 948-6200 |
| NPI Number | 1063061117 |
|---|---|
| Provider Enumeration Date | 09/10/2019 |
| Last Update Date | 10/03/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063061117 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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