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Organization
BREAKING THE CYCLE OF ADDICTION
Active
Organization
BREAKING THE CYCLE OF ADDICTION
Active
Other names
BREAKING THE CYCLE OF ADDICTION
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARION CORNELIUS WOLFE JR. MSW/ACSW (PRESIDENT)
(916) 583-1035
Entity
Organization
Contact information
Practice address
6011 STACY AVE, SACRAMENTO, CA 95823-3945
(916) 583-1035
Mailing address
6011 STACY AVE, SACRAMENTO, CA 95823-3945
(916) 583-1035
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1780942334
NPI-PERSONAL
CA
Enumeration date
04/03/2019
Last updated
02/20/2020
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