| Quantom-leap, Inc. | |
|
22368 South 6th Street Dos Palos CA 93665 | |
| (559) 244-1789 | |
| Not Available |
| Full Name | Quantom-leap, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 22368 South 6th Street, Dos Palos, California |
| Authorized Official Name and Position | Carmen Maroney (ADMINISTRATOR) |
| Authorized Official Contact | 5592441789 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Quantom-leap, Inc. 7299 N Channing Way Fresno CA 93711-0487 Ph: () - | Quantom-leap, Inc. 22368 South 6th Street Dos Palos CA 93665 Ph: (559) 244-1789 |
| NPI Number | 1215007695 |
|---|---|
| Provider Enumeration Date | 11/09/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215007695 | NPI | - | NPPES |
| 24004AP | Other | CA | MEDI-CAL PROVIDER NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |