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1770939308
NICHOLAS JAMES EDGE
SOUTH LAKE TAHOE, CA
NPI
1770939308
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Additional Taxonomies
101YM0800X Counselor, Mental Health
Enumeration Date
2016-05-12
Last Update Date
2024-06-25
Business Address
NICHOLAS JAMES EDGE
1900 LAKE TAHOE BLVD
SOUTH LAKE TAHOE, CA 96150-6305
Phone number: 530-573-7970
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Mailing Address
NICHOLAS JAMES EDGE
995 GATEWAY CENTER WAY
SAN DIEGO, CA 92102-4500
Phone number: 619-398-2196
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