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Organization
YELLOWSTONE WOMEN'S FIRST STEP HOUSE INC.
Active
Organization
YELLOWSTONE WOMEN'S FIRST STEP HOUSE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN SPENCER RADT 1 (PROGRAM MANAGER)
(949) 678-3014
Entity
Organization
Contact information
Practice address
2001 HARBOR BLVD, SUITE 200, COSTA MESA, CA 92626
(888) 941-9048
(949) 646-5296
Mailing address
154 E BAY ST, COSTA MESA, CA 92627-2147
(888) 941-9048
(949) 646-5296
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
300121IN
CA
Other
Enumeration date
04/28/2016
Last updated
04/28/2016
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