Provider Demographics
NPI:1275064180
Name:MENTAL HEALTH SYSTEMS SUCCESS FIRST
Entity Type:Organization
Organization Name:MENTAL HEALTH SYSTEMS SUCCESS FIRST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY SPECIALIST
Authorized Official - Prefix:MISS
Authorized Official - First Name:CLAUDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:JUAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-980-2789
Mailing Address - Street 1:9540 CENTER AVE SUITE 100
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730
Mailing Address - Country:US
Mailing Address - Phone:909-980-2789
Mailing Address - Fax:909-980-2689
Practice Address - Street 1:9540 CENTER AVE
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-5840
Practice Address - Country:US
Practice Address - Phone:909-980-2789
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-22
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health