| Prototypes | |
|
831 E Arrow Hwy Pomona CA 91767-2535 | |
| (909) 624-1233 | |
| Not Available |
| Full Name | Prototypes |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 831 E Arrow Hwy, Pomona, California |
| Authorized Official Name and Position | Evanne Bree Jackson (SUD COUNSELOR II) |
| Authorized Official Contact | 9096241233 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prototypes 831 E Arrow Hwy Pomona CA 91767-2535 Ph: (909) 624-1233 | Prototypes 831 E Arrow Hwy Pomona CA 91767-2535 Ph: (909) 624-1233 |
| NPI Number | 1265069355 |
|---|---|
| Provider Enumeration Date | 03/26/2020 |
| Last Update Date | 03/27/2020 |
| Certification Date | 03/27/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265069355 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (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 | |
Live Individuate Vibrate Evolve And Expand - Live Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1554 Sout Garey Ave, Apt C, Pomona, CA 91766 Phone: 909-455-7733 Fax: 866-598-3594 | |
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 |