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Organization
LAGS SPINE AND SPORTSCARE MEDICAL CENTERS, INC.
Active
Organization
LAGS SPINE AND SPORTSCARE MEDICAL CENTERS, INC.
Active
Other names
LAGS Recovery Centers
Organization subpart
No
Provider details
NPI number
Authorized official
AMY D'AMATO (CONTRACTS MANAGER)
(805) 264-3388
Entity
Organization
Contact information
Practice address
1223 HIGUERA ST STE 101, SAN LUIS OBISPO, CA 93401-3167
(805) 541-8581
Mailing address
218 N I ST, LOMPOC, CA 93436-0909
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
103T00000X
Psychologist
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
106H00000X
Marriage & Family Therapist
—
—
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
—
—
2084P0802X
Addiction Psychiatry Physician
—
—
Other
Enumeration date
04/23/2018
Last updated
04/23/2018
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