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Organization
7TH AVENUE CENTER, LLC
Active
Organization
7TH AVENUE CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANN M. BUTLER (PRESIDENT)
(831) 420-0120
Entity
Organization
Contact information
Practice address
1171 7TH AVE, SANTA CRUZ, CA 95062-2714
(831) 420-0120
(831) 420-0136
Mailing address
2115 7TH AVE, SANTA CRUZ, CA 95062-1663
(831) 420-0120
(831) 420-0136
Taxonomy
Speciality
Code
Description
License number
State
310500000X
Mental Illness Intermediate Care Facility
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
44B7
MEDI-CAL PRV NBR
CA
Enumeration date
12/20/2006
Last updated
03/23/2012
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