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Organization
STEP UP ON SECOND ACT PROGRAM
Active
Organization
STEP UP ON SECOND ACT PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MICHELLE A. JENSEN M.S. (CLINICAL CASE MANGER)
(715) 212-6855
Entity
Organization
Contact information
Practice address
3435 OCEAN PARK BLVD, SANTA MONICA, CA 90405-3301
(310) 392-9474
Mailing address
3435 OCEAN PARK BLVD, SANTA MONICA, CA 90405-3301
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
NULL
Other
Enumeration date
07/31/2008
Last updated
07/31/2008
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