| Lds Family Services Ca Fountain Valley | |
|
17350 Mount Herrmann St Suite A Fountain Valley CA 92708-4114 | |
| (714) 444-3463 | |
| (714) 444-1768 |
| Full Name | Lds Family Services Ca Fountain Valley |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 17350 Mount Herrmann St, Fountain Valley, California |
| Authorized Official Name and Position | Todd Hunter Huisken (DIRECTOR) |
| Authorized Official Contact | 7144443463 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lds Family Services Ca Fountain Valley 17350 Mount Herrmann St Suite A Fountain Valley CA 92708-4114 Ph: (714) 444-3463 | Lds Family Services Ca Fountain Valley 17350 Mount Herrmann St Suite A Fountain Valley CA 92708-4114 Ph: (714) 444-3463 |
| NPI Number | 1104906098 |
|---|---|
| Provider Enumeration Date | 10/16/2006 |
| Last Update Date | 06/06/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104906098 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (California) | Primary |
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