Organization · NPI-2

Imperial Valley Wellness Center

Clinic/Center · Brawley, CA

NPI number1619364650
StatusActive
Last updated in NPPESApr 16, 2015

Details

NPI
1619364650
Entity type
Organization (NPI-2)
Legal business name
Imperial Valley Wellness Center
Organization subpart
No
Enumeration date
Apr 16, 2015
Last updated
Apr 16, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261Q00000X Clinic/Center––Yes

Practice location

578 G St
Brawley, CA 92227-2411

Phone 760-344-2157 · Fax 760-344-2203

Mailing address

578 G St
Brawley, CA 92227-2411

Phone 760-344-2157 · Fax 760-344-2203

Authorized official

Socorro Escalante
Manager
7603442157

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