Organization
A WILDWOOD RECOVERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WALTER THOMAS M.D. (PRESIDENT)
(805) 493-5741
Entity
Organization
Contact information
Practice address
360 CAMINO DE CELESTE, THOUSAND OAKS, CA 91360-7124
(805) 493-5741
(805) 493-5047
Mailing address
360 CAMINO DE CELESTE, THOUSAND OAKS, CA 91360-7124
(805) 493-5741
(805) 493-5047
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
560040AP
CA
Other
Enumeration date
07/05/2011
Last updated
06/20/2012
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