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Organization
MTN. SHADOWS ANCILLARY SERVICES
Active
Organization
MTN. SHADOWS ANCILLARY SERVICES
Active
Other names
Spectrum Solutions
Organization subpart
No
Provider details
NPI number
Authorized official
ARLENE GALVAN (PROGRAM DIRECTOR)
(760) 743-3714
Entity
Organization
Contact information
Practice address
970 LOS VALLECITOS BLVD, SUITE 140, SAN MARCOS, CA 92069-1473
(760) 743-3714
Mailing address
970 LOS VALLECITOS BLVD, SUITE 240, SAN MARCOS, CA 92069-1473
(760) 743-3714
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BL12021639
BUSINESS LICENSE
CA
Enumeration date
11/06/2014
Last updated
11/13/2014
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