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1720472756
PERRY WAYNE LONG
CERES, CA
NPI
1720472756
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2015-03-27
Last Update Date
2015-03-27
Business Address
Mr. PERRY WAYNE LONG CADC II CA
1904 RICHLAND AVE
CERES, CA 95307-4562
Phone number: 209-541-2121
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Mailing Address
Mr. PERRY WAYNE LONG CADC II CA
1904 RICHLAND AVE
CERES, CA 95307-4562
Phone number: 209-541-2121
Copy
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