Provider Demographics
NPI:1952538019
Name:VINE CARE CENTER INC
Entity Type:Organization
Organization Name:VINE CARE CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NKECHI
Authorized Official - Middle Name:
Authorized Official - Last Name:ANWULI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-677-7900
Mailing Address - Street 1:26413 JEFFERSON AVE
Mailing Address - Street 2:H
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-6979
Mailing Address - Country:US
Mailing Address - Phone:951-677-7900
Mailing Address - Fax:951-677-6877
Practice Address - Street 1:26413 JEFFERSON AVE
Practice Address - Street 2:H
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-6979
Practice Address - Country:US
Practice Address - Phone:951-677-7900
Practice Address - Fax:951-677-6877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-16
Last Update Date:2009-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty