FARA S ELLIS

MOJAVE, CA
NPI1053608091
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA  E0703181755)
Enumeration Date2011-06-28
Last Update Date2016-08-31
Business Address
-- FARA S ELLIS RAS
16940 HIGHWAY 14 STE F
MOJAVE, CA 93501-1238
Phone number: 661-824-5020
Mailing Address
-- FARA S ELLIS RAS
21521 WESTWOOD BLVD
TEHACHAPI, CA 93561-9445
Phone number: 661-822-5171
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