| Mile High Residential and Behavioral Health | |
|
1116 Legend Cir Vallejo CA 94591-8679 | |
| (707) 647-3972 | |
| Not Available |
| Full Name | Mile High Residential and Behavioral Health |
|---|---|
| Speciality | Foster Care Agency |
| Location | 1116 Legend Cir, Vallejo, California |
| Authorized Official Name and Position | Tegre Miles (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 5106817988 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mile High Residential and Behavioral Health 3871 Quarryville Ct Fairfield CA 94533-6651 Ph: (510) 681-7988 | Mile High Residential and Behavioral Health 1116 Legend Cir Vallejo CA 94591-8679 Ph: (707) 647-3972 |
| NPI Number | 1265023915 |
|---|---|
| Provider Enumeration Date | 01/26/2021 |
| Last Update Date | 01/26/2021 |
| Certification Date | 01/26/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265023915 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | () | Secondary |
| 253J00000X | Foster Care Agency | () | Primary |
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