DAVID LISAK

GRASS VALLEY, CA
NPI1386185031
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA  MRT2525)
Enumeration Date2017-03-14
Last Update Date2017-03-14
Business Address
-- DAVID LISAK
256 BUENA VISTA ST
GRASS VALLEY, CA 95945-7239
Phone number: 530-274-2000
Mailing Address
-- DAVID LISAK
256 BUENA VISTA ST
GRASS VALLEY, CA 95945-7239
Phone number: 530-274-2000