| NPI | 1477004802 |
|---|---|
| Former Name | JOHN ACEVES FLORES |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA R1-F1109112058) |
| Enumeration Date | 2016-10-20 |
| Last Update Date | 2016-10-20 |