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College Community Services

Community/Behavioral Health in Orange, CA. Organization (NPI-2).

NPI number1750831889
StatusActive
Last updated in NPPESJun 3, 2024

Details

NPI
1750831889
Entity type
Organization (NPI-2)
Legal business name
College Community Services
Organization subpart
No
Enumeration date
Oct 13, 2016
Certification date
Jun 3, 2024
Last updated
Jun 3, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
251S00000X Community/Behavioral Health––Yes
302R00000X Health Maintenance Organization––

Other names

  • Wellness Center (Other Name)
  • Clarvida (Doing Business As)

Practice location

401 S Tustin St
Building #c
Orange, CA 92866-2550

Phone 714-361-4860

Mailing address

8337 Telegraph Rd Ste 300
Pico Rivera, CA 90660-4957

Phone 562-467-5440 · Fax 562-467-5553

Authorized official

Tracy Ginter
Director Of State Operations
6574659497

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