| Mhsa Fsp Mdft Lake Elsinore | |
|
31946 Mission Trl Ste B Lake Elsinore CA 92530-4539 | |
| (951) 443-2200 | |
| Not Available |
| Full Name | Mhsa Fsp Mdft Lake Elsinore |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 31946 Mission Trl Ste B, Lake Elsinore, California |
| Authorized Official Name and Position | Matthew Chang (DIRECTOR RUHS - BEHAVIORAL HEALTH) |
| Authorized Official Contact | 9513584500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mhsa Fsp Mdft Lake Elsinore Po Box 7659 Riverside CA 92513 Ph: (951) 358-6900 | Mhsa Fsp Mdft Lake Elsinore 31946 Mission Trl Ste B Lake Elsinore CA 92530-4539 Ph: (951) 443-2200 |
| NPI Number | 1528242799 |
|---|---|
| Provider Enumeration Date | 12/24/2007 |
| Last Update Date | 09/09/2022 |
| Certification Date | 09/09/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528242799 | NPI | - | NPPES |
| 00033 | Other | CA | LEGAL ENTITY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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