| Captive Hearts | |
|
882 W Grand Ave Grover Beach CA 93433-2134 | |
| (805) 481-4500 | |
| Not Available |
| Full Name | Captive Hearts |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 882 W Grand Ave, Grover Beach, California |
| Authorized Official Name and Position | Elissa Rose Goodenough (BOARD MEMBER/ EMPLOYEE) |
| Authorized Official Contact | 8056028751 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Captive Hearts 882 W Grand Ave Grover Beach CA 93433-2134 Ph: (805) 602-8751 | Captive Hearts 882 W Grand Ave Grover Beach CA 93433-2134 Ph: (805) 481-4500 |
| NPI Number | 1457975351 |
|---|---|
| Provider Enumeration Date | 06/05/2020 |
| Last Update Date | 06/17/2020 |
| Certification Date | 06/17/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457975351 | NPI | - | NPPES |
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