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Organization
W.P.R. LLC
Active
Organization
W.P.R. LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW JOHNSON (PRESIDENT)
(209) 276-8892
Entity
Organization
Contact information
Practice address
2733 COUNTRY CLUB BLVD APT 87, STOCKTON, CA 95204-3975
(209) 276-8892
Mailing address
9919 MARQUAND DR, BURKE, VA 22015-3808
(206) 201-9454
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
311Z00000X
Custodial Care Facility
—
—
Other
Enumeration date
09/12/2018
Last updated
09/26/2020
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