Provider Demographics
NPI:1104542216
Name:OPERANT SERVICES
Entity type:Organization
Organization Name:OPERANT SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:RAGI
Authorized Official - Middle Name:
Authorized Official - Last Name:BOCTOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-504-0116
Mailing Address - Street 1:PO BOX 53413
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92619-3413
Mailing Address - Country:US
Mailing Address - Phone:714-504-0116
Mailing Address - Fax:714-333-4535
Practice Address - Street 1:6529 RIVERSIDE AVE STE 230
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-3126
Practice Address - Country:US
Practice Address - Phone:951-228-2832
Practice Address - Fax:714-333-4535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-19
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health