Organization
COMPREHENSIVE ADDICTION PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRITTANI ANNE FANCIULLO (MONITOR)
(559) 264-5096
Entity
Organization
Contact information
Practice address
4647 N CHESTNUT AVE APT 101, FRESNO, CA 93726-1803
(559) 365-3450
Mailing address
4647 N CHESTNUT AVE APT 101, FRESNO, CA 93726-1803
(559) 365-3450
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
101YA04000X
CA
Other
Enumeration date
08/24/2016
Last updated
08/24/2016
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