| Pes-ebs.inc. | |
|
340 Lincoln St Roseville CA 95678-2230 | |
| (530) 863-4720 | |
| (530) 888-9065 |
| Full Name | Pes-ebs.inc. |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 340 Lincoln St, Roseville, California |
| Authorized Official Name and Position | Debora Anne Martin (PROGRAM DIRECTOR) |
| Authorized Official Contact | 5308634720 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pes-ebs.inc. 11837 Kemper Rd Ste 2 Auburn CA 95603-9067 Ph: (530) 863-4720 | Pes-ebs.inc. 340 Lincoln St Roseville CA 95678-2230 Ph: (530) 863-4720 |
| NPI Number | 1316295082 |
|---|---|
| Provider Enumeration Date | 08/28/2012 |
| Last Update Date | 08/28/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316295082 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 310021AP (California) | Primary |
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