| NPI | 1750689915 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WIM VERKAIK Director Of Administration 805-963-1433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 1501) |
| Additional Taxonomies | 251S00000X (Licence: CA 1501) |
| Enumeration Date | 2011-03-11 |
| Last Update Date | 2011-03-11 |