Provider Demographics
NPI:1912236977
Name:RA NEAL HEALTH ADVISORY CENTER INC
Entity Type:Organization
Organization Name:RA NEAL HEALTH ADVISORY CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:NEAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-415-2632
Mailing Address - Street 1:28940 GREENSPOT RD
Mailing Address - Street 2:STE 217
Mailing Address - City:HIGHLAND
Mailing Address - State:CA
Mailing Address - Zip Code:92346-4423
Mailing Address - Country:US
Mailing Address - Phone:909-415-2632
Mailing Address - Fax:
Practice Address - Street 1:28940 GREENSPOT RD
Practice Address - Street 2:STE 217
Practice Address - City:HIGHLAND
Practice Address - State:CA
Practice Address - Zip Code:92346-4423
Practice Address - Country:US
Practice Address - Phone:909-415-2632
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-21
Last Update Date:2009-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty