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Organization
SAMUEL T. ENTERPRISE
Active
Organization
SAMUEL T. ENTERPRISE
Active
Other names
LifeLine Health Solutions
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LINDA JEAN TESORO MFT (ADMINISTRATOR)
(714) 847-7585
Entity
Organization
Contact information
Practice address
3151 AIRWAY AVE, SUITE D2, COSTA MESA, CA 92626-4607
(714) 847-7585
(714) 848-5410
Mailing address
3151 AIRWAY AVE, SUITE D2, COSTA MESA, CA 92626-4607
(714) 847-7585
(714) 848-5410
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
Other
Enumeration date
09/23/2015
Last updated
09/23/2015
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