Organization Name: | TESSIE CLEVELAND COMMUNITY SERVICES |
NPI Number: | 1003293721 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CAROLYN CHADWICK (CHIEF OPERATING OFFICER) |
Mailing Address: | 450 W Palmdale Blvd Suite B Palmdale |
State: | CA US |
Postal Code: | 935513104 |
Phone Number: | 3235867333 |
Fax Number: | 3109659791 |
NPI Enumeration Date: | 05/01/2015 |
NPI Last Update Date: | 11/03/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QM0801X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Mental Health (Including Community Mental Health Center) |
Taxonomy Definition: |