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Organization

ADDICTION THERAPEUTIC SERVICES

Active
Parent organization
J. HERNDONS LLC
Other names
Addiction Therapeutic Services
Organization subpart
Yes

Provider details

NPI number
Legal business name
J. HERNDONS LLC
Authorized official
JOSEPHINE HERNDON (CEO)
(760) 413-2055
Entity
Organization

Contact information

Practice address
303 E MAIN ST, BARSTOW, CA 92311-2325
(760) 957-7479
(760) 957-7416
Mailing address
303 E MAIN ST, BARSTOW, CA 92311-2325
(760) 957-7479
(760) 957-7479

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
305R00000X
Preferred Provider Organization
Primary

Other

Enumeration date
02/13/2020
Last updated
05/14/2024
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