Provider Demographics
NPI:1427423953
Name:HEALTH CARE AGENCY
Entity type:Organization
Organization Name:HEALTH CARE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER I
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:A
Authorized Official - Last Name:FOLLMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-395-5052
Mailing Address - Street 1:42 VIA FLORENCIA
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92692-5961
Mailing Address - Country:US
Mailing Address - Phone:949-395-5052
Mailing Address - Fax:
Practice Address - Street 1:42 VIA FLORENCIA
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92692-5961
Practice Address - Country:US
Practice Address - Phone:949-395-5052
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-09
Last Update Date:2015-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health