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Organization
ICBHS
Active
Organization
ICBHS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY GARRISON (SUBSTANCE AUBSE COUNSELOR II)
(760) 353-0763
Entity
Organization
Contact information
Practice address
1295 W STATE ST, STE. 102, EL CENTRO, CA 92243-2845
(760) 353-0763
Mailing address
1295 W STATE ST, STE. 102, EL CENTRO, CA 92243-2845
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
03/23/2007
Last updated
08/22/2020
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