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1508387473
JIMMY LACEY
PASADENA, CA
NPI
1508387473
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA R1242210117)
Enumeration Date
2017-06-30
Last Update Date
2022-07-21
Business Address
JIMMY LACEY
1230 N MARENGO AVE
PASADENA, CA 91103-2217
Phone number: 626-797-1124
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Mailing Address
JIMMY LACEY
1230 N MARENGO AVE
PASADENA, CA 91103-2217
Phone number: 626-797-1124
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