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Organization
CO. OF SAN LUIS OBISPO
Active
Organization
CO. OF SAN LUIS OBISPO
Active
Other names
san luis obispo county drug and alcohol service
Organization subpart
No
Provider details
NPI number
Authorized official
MADALYN BETHANN HANSEN M-R.A.S. (CASE MANAGER)
(805) 704-7612
Entity
Organization
Contact information
Practice address
1523 LONGBRANCH AVE, GROVER BEACH, CA 93433-2508
(805) 473-7080
(805) 473-7188
Mailing address
1523 LONGBRANCH AVE, GROVER BEACH, CA 93433-2508
(805) 473-7080
(805) 473-7188
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
P0602150905
CA
Other
Enumeration date
08/19/2014
Last updated
08/19/2014
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