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1104246818
JORGE PENA
CEDAR RAPIDS, IA
NPI
1104246818
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: IA 1370)
Enumeration Date
2014-04-21
Last Update Date
2014-04-21
Business Address
-- JORGE PENA CADC
4403 1ST AVE SE STE 104
CEDAR RAPIDS, IA 52402-3221
Phone number: 319-423-0919
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Mailing Address
-- JORGE PENA CADC
4403 1ST AVE SE STE 104
CEDAR RAPIDS, IA 52402-3221
Phone number: 319-423-0919
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