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Organization
COMMON GOALS
Active
Organization
COMMON GOALS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HAROLD JOSEPH BORDENAVE III CSAC (DRUG COUNSELOR)
(530) 344-6457
Entity
Organization
Contact information
Practice address
727 ZION ST, NEVADA CITY, CA 95959-2920
(530) 265-2914
(530) 265-2974
Mailing address
727 ZION ST, NEVADA CITY, CA 95959-2920
(530) 265-2914
(530) 265-2974
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
N/A
N/A
CA
Enumeration date
07/09/2012
Last updated
07/18/2012
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