| San Luis Obispo Center For Change | |
|
285 South St Suite M San Luis Obispo CA 93401-5037 | |
| (805) 544-2892 | |
| (805) 544-2887 |
| Full Name | San Luis Obispo Center For Change |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 285 South St, San Luis Obispo, California |
| Authorized Official Name and Position | Dave Davis (COUNSELOR) |
| Authorized Official Contact | 8055442892 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| San Luis Obispo Center For Change 285 South St Suite M San Luis Obispo CA 93401-5037 Ph: (805) 544-2892 | San Luis Obispo Center For Change 285 South St Suite M San Luis Obispo CA 93401-5037 Ph: (805) 544-2892 |
| NPI Number | 1861673964 |
|---|---|
| Provider Enumeration Date | 11/16/2007 |
| Last Update Date | 11/16/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861673964 | NPI | - | NPPES |
| 6059 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
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