Provider First Line Business Practice Location Address:
1119 EAST MONTE VISTA AVE, MS 32-175
Provider Second Line Business Practice Location Address:
INTEGRATED CARE CLINIC - ADULT MENTAL HEALTH
Provider Business Practice Location Address City Name:
VACAVILLE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95688
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
707-469-4664
Provider Business Practice Location Address Fax Number:
707-448-1119
Provider Enumeration Date:
09/23/2015