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Organization
PATRIOT COUNSELING SERVICES
Active
Organization
PATRIOT COUNSELING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLA ANN RUSH MS, CATC IV, MAC, SA (PRESIDENT OF AGENCY AND TREATMENT P)
(775) 848-9771
Entity
Organization
Contact information
Practice address
545 W SIERRA ST, PORTOLA, CA 96122-8615
(775) 848-9771
Mailing address
165 RIDGE ST, PORTOLA, CA 96122-8609
(775) 848-9771
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
03/05/2017
Last updated
03/17/2017
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