Madeline C Douglas
Clinic/Center, Mental Health (Including Community Mental Health Center) in Redlands, CA. Organization (NPI-2).
NPI number1992551691
StatusActive
Last updated in NPPESApr 24, 2024
Details
- NPI
- 1992551691
- Entity type
- Organization (NPI-2)
- Legal business name
- Madeline C Douglas
- Organization subpart
- No
- Enumeration date
- Apr 24, 2024
- Certification date
- Apr 24, 2024
- Last updated
- Apr 24, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM0801X | Clinic/Center, Mental Health (Including Community Mental Health Center) | – | – | Yes |
Other names
- Madeline C Douglas (Doing Business As)
Practice location
1255 W Colton AveRedlands, CA 92374-2861
Phone 909-363-4661 · Fax 909-495-1634
Mailing address
Po Box 1023San Bernardino, CA 92402-1023
Phone 217-607-4215 · Fax 909-495-1634
Authorized official
Madeline C Douglas
Owner
2176074215
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