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Organization

DEPARTMENT OF ALCOHOL AND DRUG SERVICES

Active
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Organization

DEPARTMENT OF ALCOHOL AND DRUG SERVICES

Active
Other names
Central Treatment and Recovery
Organization subpart
No

Provider details

NPI number
Authorized official
MR. BOB GARDNER MA (DIRECTOR)
(408) 792-5656
Entity
Organization

Contact information

Practice address
976 LENZEN AVE FL 1, SAN JOSE, CA 95126-2737
(408) 792-5643
(408) 947-8719
Mailing address
976 LENZEN AVE FL 1, SAN JOSE, CA 95126-2737
(408) 792-5643
(408) 947-8719

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
CA
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—

Other

Enumeration date
04/04/2007
Last updated
08/22/2020
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