Organization
FRONT STREET
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANN BUTLER (PRESIDENT)
(831) 334-1754
Entity
Organization
Contact information
Practice address
2115 7TH AVE, SANTA CRUZ, CA 95062-1663
(831) 420-0120
Mailing address
2115 7TH AVE, SANTA CRUZ, CA 95062-1663
(831) 420-0120
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
445202099
CA
Other
Enumeration date
07/18/2012
Last updated
07/18/2012
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