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1497889182
OTTIS JOHNSON
LAKE ELSINORE, CA
NPI
1497889182
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA 03-039448)
Enumeration Date
2007-03-15
Last Update Date
2007-07-08
Business Address
Mr. OTTIS JOHNSON C.A.S.
565 CHANEY ST
LAKE ELSINORE, CA 92530-2722
Phone number: 951-674-5354
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Mailing Address
Mr. OTTIS JOHNSON C.A.S.
565 CHANEY ST
LAKE ELSINORE, CA 92530-2722
Phone number: 951-674-5354
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