Organization
ADDICTION INTERVENTION RESOURCES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LINDA GIBSON (ADMINISTRATOR)
(559) 486-3146
Entity
Organization
Contact information
Practice address
405 N BROADWAY ST, FRESNO, CA 93701-1513
(559) 486-3146
(559) 486-3146
Mailing address
405 N BROADWAY ST, FRESNO, CA 93701-1513
(559) 486-3146
(559) 486-3146
Taxonomy
Speciality
Code
Description
License number
State
3245S0500X
Children's Substance Abuse Rehabilitation Facility
Primary
1006
CA
Other
Enumeration date
06/04/2007
Last updated
08/22/2020
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