| NPI | 1649601550 |
|---|---|
| Doing Business As | COMMUNITY CLINIC SOUTH |
| Entity Type | Organization |
| Authorized Contact | AMBER WILLIAMS Chief Executive Officer 831-278-7906 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic |
| Additional Taxonomies | 251S00000X (Licence: CA 44-06) |
| 251S00000X | |
| 261QM2800X Clinic/Center, Methadone Clinic (Licence: CA 4405) | |
| Enumeration Date | 2013-12-02 |
| Last Update Date | 2022-02-23 |