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1376901017
DOUGLAS ANTHONY TUCKER
SANTA ANA, CA
NPI
1376901017
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
324500000X Substance Abuse Rehabilitation Facility
(Licence: CA 300033CN)
Enumeration Date
2016-02-09
Last Update Date
2016-02-09
Business Address
Mr. DOUGLAS ANTHONY TUCKER MHS CATC IV 155671
1207 E FRUIT ST
SANTA ANA, CA 92701-4206
Phone number: 714-953-9373
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Mailing Address
Mr. DOUGLAS ANTHONY TUCKER MHS CATC IV 155671
1207 E FRUIT ST
SANTA ANA, CA 92701-4206
Phone number: 714-953-9373
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