| South Bay Teen Recovery Center | |
|
2429 Fenton St Suite A Chula Vista CA 91914-3517 | |
| (619) 482-9300 | |
| Not Available |
| Full Name | South Bay Teen Recovery Center |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 2429 Fenton St, Chula Vista, California |
| Authorized Official Name and Position | Jeanne Mcalister (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 6194420277 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| South Bay Teen Recovery Center 1400 N Johnson Ave Suite 101 El Cajon CA 92020-1650 Ph: (619) 442-0277 | South Bay Teen Recovery Center 2429 Fenton St Suite A Chula Vista CA 91914-3517 Ph: (619) 482-9300 |
| NPI Number | 1891916292 |
|---|---|
| Provider Enumeration Date | 05/01/2007 |
| Last Update Date | 09/18/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891916292 | NPI | - | NPPES |
| 37-8542 | Other | CA | MEDICAL PROVIDER NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 370045ADN (Colorado) | Primary |
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