| Alcohol And Drug Program-ccc Program | |
|
3974 Durock Rd Ste 205 Shingle Springs CA 95682-8568 | |
| (530) 621-6659 | |
| Not Available |
| Full Name | Alcohol And Drug Program-ccc Program |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 3974 Durock Rd Ste 205, Shingle Springs, California |
| Authorized Official Name and Position | Salina Marie Drennan (SUDS PROGRAM ADMINISTRATOR) |
| Authorized Official Contact | 5306216207 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Alcohol And Drug Program-ccc Program 768 Pleasant Valley Rd Ste 201 Diamond Springs CA 95619-9260 Ph: (530) 621-6146 | Alcohol And Drug Program-ccc Program 3974 Durock Rd Ste 205 Shingle Springs CA 95682-8568 Ph: (530) 621-6659 |
| NPI Number | 1720505779 |
|---|---|
| Provider Enumeration Date | 08/29/2017 |
| Last Update Date | 09/25/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720505779 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
Bridging Differences Aba Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 7520 S Shingle Rd, Shingle Springs, CA 95682 Phone: 530-280-5531 Fax: 208-518-1286 |