Provider First Line Business Practice Location Address:
125 W.MISSION AVE
Provider Second Line Business Practice Location Address:
SUITE 103 NORTH INLAND MENTAL HEALTH CENTER
Provider Business Practice Location Address City Name:
ESCONDIDO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92025
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-747-3424
Provider Business Practice Location Address Fax Number:
760-747-3435
Provider Enumeration Date:
11/29/2006