Organization
FREE AT LAST CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH CHEWNING (PROGRAM ADMINISTRATION)
(650) 462-6995
Entity
Organization
Contact information
Practice address
1796 BAY RD, EAST PALO ALTO, CA 94303-1611
(650) 462-6999
(650) 462-1055
Mailing address
1796 BAY RD, EAST PALO ALTO, CA 94303-1611
(650) 462-6999
(650) 462-1055
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
410027IN
CA
251S00000X
Community/Behavioral Health Agency
410027IN
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
410027IN
REHABILITATION SERVICES
—
Enumeration date
09/26/2013
Last updated
09/26/2013
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