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1215064555
MARIO ISRAEL MORENO
LA PUENTE, CA
NPI
1215064555
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2007-02-27
Last Update Date
2007-07-08
Business Address
Mr. MARIO ISRAEL MORENO
15229 AMAR RD
LA PUENTE, CA 91744-2066
Phone number: 626-855-5090
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Mailing Address
Mr. MARIO ISRAEL MORENO
1350 S CANDISH AVE
GLENDORA, CA 91740-5800
Phone number: 626-260-2605
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