Organization
CO. OF SAN LUIS OBISPO
Active
Other names
san luis obispo county drug and alcohol service
Organization subpart
No
Provider details
NPI number
Authorized official
MADALYN BETHANN HANSEN M-R.A.S. (CASE MANAGER)
(805) 704-7612
Entity
Organization
Contact information
Practice address
1523 LONGBRANCH AVE, GROVER BEACH, CA 93433-2508
(805) 473-7080
(805) 473-7188
Mailing address
1523 LONGBRANCH AVE, GROVER BEACH, CA 93433-2508
(805) 473-7080
(805) 473-7188
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
P0602150905
CA
Other
Enumeration date
08/19/2014
Last updated
08/19/2014
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