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220 Euclid Ave Suite 40 San Diego CA 92114-3644 | |
| (858) 518-2192 | |
| (858) 874-8149 |
| Full Name | |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 220 Euclid Ave, San Diego, California |
| Authorized Official Name and Position | Robert Dean (CEO) |
| Authorized Official Contact | 8585145100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
8910 Clairemont Mesa Blvd San Diego CA 92123-1104 Ph: (858) 514-5100 | 220 Euclid Ave Suite 40 San Diego CA 92114-3644 Ph: (858) 518-2192 |
| NPI Number | 1730567199 |
|---|---|
| Provider Enumeration Date | 05/18/2015 |
| Last Update Date | 12/29/2020 |
| Certification Date | 12/29/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730567199 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
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