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Organization

BODHI ADDICTION TREATMENT AND WELLNESS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JONATHAN BEAZLEY CADC-CAS , RAS II (OWNER)
(831) 600-6021
Entity
Organization

Contact information

Practice address
603 CAPITOLA AVE, CAPITOLA, CA 95010-2751
(831) 600-6021
Mailing address
710 BEVERLY AVE, CAPITOLA, CA 95010-2780
(831) 600-6021

Taxonomy

Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary

Other

Enumeration date
01/25/2021
Last updated
01/26/2021
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