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Organization

PREPARING PEOPLE FOR SUCCESS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SHAWN VAUGHAN-WILLIAMS CADC-II (EXECUTIVE DIRECTOR)
(916) 575-8851
Entity
Organization

Contact information

Practice address
1513 SPORTS DR, SACRAMENTO, CA 95834-1943
(916) 575-8851
Mailing address
1513 SPORTS DR, SACRAMENTO, CA 95834-1943
(916) 575-8851

Taxonomy

Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
121528933
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1215287933
ALCOHOL AND DRUG
CA
Enumeration date
01/15/2015
Last updated
01/15/2015
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