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Organization
PASSPORT TO ADAPTIVE LIVING
Active
Organization
PASSPORT TO ADAPTIVE LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILSON JEREMY (DIRECTOR)
(805) 339-0210
Entity
Organization
Contact information
Practice address
1673 DONLON ST STE 204, VENTURA, CA 93003-5668
(805) 339-0210
(805) 642-3757
Mailing address
1673 DONLON ST STE 204, VENTURA, CA 93003-5668
(805) 339-0210
(805) 642-3757
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
05/21/2012
Last updated
05/21/2012
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