| Alcohol And Drug Program-south Lake Tahoe | |
|
1900 Lake Tahoe Blvd South Lake Tahoe CA 96150-6305 | |
| (530) 621-6207 | |
| Not Available |
| Full Name | Alcohol And Drug Program-south Lake Tahoe |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1900 Lake Tahoe Blvd, South Lake Tahoe, California |
| Authorized Official Name and Position | Salina Marie Drennan (SUDS PROGRAM ADMINISTRATOR/MANAGER) |
| Authorized Official Contact | 5306216207 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Alcohol And Drug Program-south Lake Tahoe 768 Pleasant Valley Rd Ste 201 Diamond Springs CA 95619-9260 Ph: (530) 621-6146 | Alcohol And Drug Program-south Lake Tahoe 1900 Lake Tahoe Blvd South Lake Tahoe CA 96150-6305 Ph: (530) 621-6207 |
| NPI Number | 1063615490 |
|---|---|
| Provider Enumeration Date | 06/05/2007 |
| Last Update Date | 09/25/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063615490 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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