| Palomares Academy | |
|
2211 N Orange Grove Ave Pomona CA 91767-2319 | |
| (323) 295-1136 | |
| (323) 195-1136 |
| Full Name | Palomares Academy |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 2211 N Orange Grove Ave, Pomona, California |
| Authorized Official Name and Position | Josephine C. Kannike-martins (CEO/EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3232951136 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Palomares Academy 3756 Santa Rosalia Dr 417 Los Angeles CA 90008-3606 Ph: (323) 295-1136 | Palomares Academy 2211 N Orange Grove Ave Pomona CA 91767-2319 Ph: (323) 295-1136 |
| NPI Number | 1154765154 |
|---|---|
| Provider Enumeration Date | 04/20/2013 |
| Last Update Date | 04/20/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154765154 | NPI | - | NPPES |
| 190636 AN | Other | CA | MEDI CAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 190636 AN (California) | Primary |
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