| NPI | 1063045482 |
|---|---|
| Doing Business As | ADDICTION THERAPEUTIC SERVICES |
| Entity Type | Organization |
| Authorized Contact | JOSEPHINE HERNDON CEO 760-413-2055 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 305R00000X Preferred Provider Organization |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2020-02-13 |
| Last Update Date | 2024-05-14 |