| Pioneer Twelve Step Outpatient Youth Program | |
|
317 W Henderson Ave Porterville CA 93257-1732 | |
| (559) 781-8585 | |
| (559) 791-0183 |
| Full Name | Pioneer Twelve Step Outpatient Youth Program |
|---|---|
| Speciality | Counselor |
| Location | 317 W Henderson Ave, Porterville, California |
| Authorized Official Name and Position | Geraldine A Ogans (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5597818585 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pioneer Twelve Step Outpatient Youth Program 317 W Henderson Ave Porterville CA 93257-1732 Ph: (559) 781-8585 | Pioneer Twelve Step Outpatient Youth Program 317 W Henderson Ave Porterville CA 93257-1732 Ph: (559) 781-8585 |
| NPI Number | 1104947787 |
|---|---|
| Provider Enumeration Date | 04/02/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104947787 | NPI | - | NPPES |
| 5442 | Other | CA | MEDI-CAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
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