Provider First Line Business Practice Location Address:
10633 GRISSOM AVE
Provider Second Line Business Practice Location Address:
VANCHCS MENTAL HEALTH CLINIC
Provider Business Practice Location Address City Name:
MATHER
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95655-4123
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-843-7037
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/23/2005