JACK D MOUNT

LAKE ELSINORE, CA
NPI1942334560
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA  02-025838)
Enumeration Date2007-03-15
Last Update Date2007-07-08
Business Address
-- JACK D MOUNT c.a.s.
565 CHANEY ST
LAKE ELSINORE, CA 92530-2722
Phone number: 951-674-5354
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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