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1942334560
JACK D MOUNT
LAKE ELSINORE, CA
NPI
1942334560
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA 02-025838)
Enumeration Date
2007-03-15
Last Update Date
2007-07-08
Business Address
-- JACK D MOUNT c.a.s.
565 CHANEY ST
LAKE ELSINORE, CA 92530-2722
Phone number: 951-674-5354
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Mailing Address
-- JACK D MOUNT c.a.s.
565 CHANEY ST
LAKE ELSINORE, CA 92530-2722
Phone number: 951-674-5354
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