| NPI | 1891539821 |
|---|---|
| Doing Business As | ATP 2- PISMO STREET HOUSE |
| Entity Type | Organization |
| Authorized Contact | JILL BOLSTOR-WHITE Executive Director 805-540-6505 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2024-06-24 |
| Last Update Date | 2024-06-24 |