| Mending Hearts Center Inc. | |
|
440 E Commonwealth Ave Ste 205 Fullerton CA 92832-2014 | |
| (714) 234-0906 | |
| Not Available |
| Full Name | Mending Hearts Center Inc. |
|---|---|
| Speciality | Counselor |
| Location | 440 E Commonwealth Ave Ste 205, Fullerton, California |
| Authorized Official Name and Position | Dennis Lee Williams (CEO) |
| Authorized Official Contact | 7142340906 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mending Hearts Center Inc. 440 E Commonwealth Ave Ste 205 Fullerton CA 92832-2014 Ph: (714) 234-0906 | Mending Hearts Center Inc. 440 E Commonwealth Ave Ste 205 Fullerton CA 92832-2014 Ph: (714) 234-0906 |
| NPI Number | 1982397030 |
|---|---|
| Provider Enumeration Date | 06/02/2023 |
| Last Update Date | 06/02/2023 |
| Certification Date | 06/02/2023 |
| Medicare PECOS PAC ID | 8729522164 |
|---|---|
| Medicare Enrollment ID | O20250129002045 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982397030 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Dennis Lee Williams |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1043715840 PECOS PAC ID: 1456895895 Enrollment ID: I20250129002102 |
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