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Organization
MS BEV ADDICTION COUNSELING AND CONSULTING SERVICES
Active
Organization
MS BEV ADDICTION COUNSELING AND CONSULTING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BEVERLY DIANE TILSON LCI2361214 (CEO/DIRECTOR)
(510) 569-9555
Entity
Organization
Contact information
Practice address
6020 OLD QUARRY LOOP, OAKLAND, CA 94605-3306
(510) 569-9555
(510) 569-9555
Mailing address
PO BOX 18665, OAKLAND, CA 94619-0665
(510) 569-9555
(510) 569-9555
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
03-068218
CA
Other
Enumeration date
09/13/2010
Last updated
04/06/2016
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