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Organization
SOUTH BAY CONNECT TREATMENT CENTER
Active
Organization
SOUTH BAY CONNECT TREATMENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ALICIA ANN MACGOWAN LCSW (FOUNDER)
(310) 776-7406
Entity
Organization
Contact information
Practice address
916 N WESTERN AVE STE 210, SAN PEDRO, CA 90732-2407
(310) 776-7406
Mailing address
916 N WESTERN AVE, SUITE 210, SAN PEDRO, CA 90732-2435
(310) 776-7406
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
21303
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1619157716
NPPES
CA
Enumeration date
10/10/2016
Last updated
07/21/2022
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