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The information below reflects the content of the TMIS information system as of the close of the previous business day. |
| Carrier ID | CA 0043763 |
| Carrier Status | Cancelled - 02/01/05 |
| Carrier Name | KNOLLWOOD PSYCHIATRIC & CHEMICAL DEPENDENCY CENTER INC |
| Phone Number | (909) 275-8400 |
| Primary DBA | KNOLLWOOD PSYCHIATRIC & CHEMICAL DEPENDENCY INC |
| Contact Address |
DONALD TIDWELL 5900 BROCKTON AVENUE RIVERSIDE, CA 92506 |
| Physical Address |
5900 BROCKTON AVENUE RIVERSIDE, CA 92506 |
| INSURANCE POLICIES | ||
| Policy Type | Policy Number | Insurance Company Address |
| PL and PD Policy | BA2302626 | FIRST NATIONAL INSR CO OF AMERICA 17570 BROOKHURST ST FOUNTAIN VALLEY, CA 92708 |