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4507 Del Rio Rd, Room 4, Principal Ofc, Counseling Ofc Atascadero CA 93422-1933 | |
| (805) 781-4753 | |
| (805) 781-1227 |
| Full Name | |
|---|---|
| Speciality | Clinic/center |
| Location | 4507 Del Rio Rd, Room 4, Principal Ofc, Counseling Ofc, Atascadero, California |
| Authorized Official Name and Position | Starlene M Graber (DIVISION MANAGER) |
| Authorized Official Contact | 8057814753 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2180 Johnson Ave San Luis Obispo CA 93401-4513 Ph: (805) 781-4753 | 4507 Del Rio Rd, Room 4, Principal Ofc, Counseling Ofc Atascadero CA 93422-1933 Ph: (805) 781-4753 |
| NPI Number | 1023350592 |
|---|---|
| Provider Enumeration Date | 03/22/2013 |
| Last Update Date | 04/02/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023350592 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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