# CO. OF SAN LUIS OBISPO

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- **Entity:** Organization
- **Status:** Active
- **Other names:** san luis obispo county drug and alcohol service
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134528805
- **Authorized official:** MADALYN BETHANN HANSEN M-R.A.S. (CASE MANAGER)
- **Authorized official phone:** (805) 704-7612

## Contact information

- **Practice address:** 1523 LONGBRANCH AVE, GROVER BEACH, CA 93433-2508
- **Practice address phone:** (805) 473-7080
- **Practice address fax:** (805) 473-7188
- **Mailing address:** 1523 LONGBRANCH AVE, GROVER BEACH, CA 93433-2508
- **Mailing address phone:** (805) 473-7080
- **Mailing address fax:** (805) 473-7188

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251B00000X | Case Management Agency | P0602150905 | CA | Yes |

## Other

- **Enumeration date:** 08/19/2014
- **Last updated:** 08/19/2014