Provider Demographics
NPI:1518298702
Name:COMMUNITY ACCESS NETWORK
Entity Type:Organization
Organization Name:COMMUNITY ACCESS NETWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE LIAISON
Authorized Official - Prefix:MISS
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MINARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-279-1333
Mailing Address - Street 1:600 CENTRAL AVE
Mailing Address - Street 2:SUITE E1
Mailing Address - City:LAKE ELSINORE
Mailing Address - State:CA
Mailing Address - Zip Code:92530-2740
Mailing Address - Country:US
Mailing Address - Phone:951-279-3222
Mailing Address - Fax:951-279-5222
Practice Address - Street 1:600 CENTRAL AVE
Practice Address - Street 2:SUITE E1
Practice Address - City:LAKE ELSINORE
Practice Address - State:CA
Practice Address - Zip Code:92530-2740
Practice Address - Country:US
Practice Address - Phone:951-471-1426
Practice Address - Fax:951-471-1453
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-27
Last Update Date:2016-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health