| Full Name | |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 700 Falcon Way, Lebec, California |
| Authorized Official Name and Position | Olga Meave (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 6616353050 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 1559 Bakersfield CA 93302-1559 Ph: (661) 635-3050 | 700 Falcon Way Lebec CA 93243 Ph: (661) 725-2788 |
| NPI Number | 1326327693 |
|---|---|
| Provider Enumeration Date | 08/04/2011 |
| Last Update Date | 02/09/2024 |
| Certification Date | 02/09/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326327693 | NPI | - | NPPES |
| 1547 | Medicaid | CA | |
| 15AN | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (California) | Primary |