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1700355757
JAMES OTTO LUCAS
LAKE HAVASU CITY, AZ
NPI
1700355757
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: AZ LISAC10723)
Enumeration Date
2018-11-20
Last Update Date
2018-11-20
Business Address
JAMES OTTO LUCAS LISAC
2080 ACOMA BLVD W UNIT A
LAKE HAVASU CITY, AZ 86403-2971
Phone number: 928-821-2424
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Mailing Address
JAMES OTTO LUCAS LISAC
2080 ACOMA BLVD W UNIT A
LAKE HAVASU CITY, AZ 86403-2971
Phone number: 928-453-8003
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