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1962825505
MICAH BASS
VICTORVILLE, CA
NPI
1962825505
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2014-02-03
Last Update Date
2014-02-03
Business Address
-- MICAH BASS Executive Director
16200 BEAR VALLEY RD STE 110
VICTORVILLE, CA 92395-8708
Phone number: 760-241-1777
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Mailing Address
-- MICAH BASS Executive Director
16200 BEAR VALLEY RD STE 110
VICTORVILLE, CA 92395-8708
Phone number: 760-241-1777
Copy
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