| Live Individuate Vibrate Evolve And Expand - Live | |
|
1554 Sout Garey Ave Apt C Pomona CA 91766-5244 | |
| (909) 455-7733 | |
| (866) 598-3594 |
| Full Name | Live Individuate Vibrate Evolve And Expand - Live |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1554 Sout Garey Ave, Pomona, California |
| Authorized Official Name and Position | Anthony C. Rucker (DIRECTOR) |
| Authorized Official Contact | 9177543691 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Live Individuate Vibrate Evolve And Expand - Live Po Box 441 Pomona CA 91769-0441 Ph: (909) 455-7733 | Live Individuate Vibrate Evolve And Expand - Live 1554 Sout Garey Ave Apt C Pomona CA 91766-5244 Ph: (909) 455-7733 |
| NPI Number | 1043049182 |
|---|---|
| Provider Enumeration Date | 07/29/2024 |
| Last Update Date | 07/29/2024 |
| Certification Date | 07/23/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043049182 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
Prototypes Centers For Innovation In Health, Mental Health And Social Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 831 E Arrow Hwy, Pomona, CA 91767 Phone: 909-398-4383 Fax: 909-398-0127 | |
Lewis Garcia Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2335 S Towne Ave, Pomona, CA 91766 Phone: 909-628-6024 Fax: 909-591-0397 | |
Pomona Alcohol & Drug Recovery Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 605 N Park Ave, Pomona, CA 91768 Phone: 909-622-2273 | |
Pomona Alcohol & Drug Recovery Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1921 Arroyo Ave, Pomona, CA 91768 Phone: 909-622-2273 Fax: 909-622-6334 | |
Medi-cure Health Services, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1460 E Holt Ave # 430, Pomona, CA 91767 Phone: 323-295-1136 Fax: 323-295-1071 | |
Open Arms Mens Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 900 E Franklin Ave, Pomona, CA 91766 Phone: 323-755-2742 Fax: 310-876-0533 |