Organization
SAN DIEGO YOUTH SERVICES
Active
Other names
Counseling Cove
Organization subpart
No
Provider details
NPI number
Authorized official
WALTER EDWIN PHILIPS LCSW (CHIEF EXECUTIVE OFFICER)
(619) 221-8601
Entity
Organization
Contact information
Practice address
3427 4TH AVE, 2ND FLOOR, SAN DIEGO, CA 92103-4910
(619) 525-9903
(619) 525-9908
Mailing address
3255 WING ST, SAN DIEGO, CA 92110-4638
(619) 221-8600
(619) 221-8611
Taxonomy
Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37H7
DMH
CA
Enumeration date
03/15/2007
Last updated
08/30/2016
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