Organization
BHS WILMINGTON COMMUNITY RECOVERY CENETER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE BONILLA (COUNSELOR)
(310) 549-2710
Entity
Organization
Contact information
Practice address
1318 N AVALON BLVD, WILMINGTON, CA 90744-2639
(310) 549-2710
Mailing address
1318 N AVALON BLVD, WILMINGTON, CA 90744-2639
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
6197-R
CA
Other
Enumeration date
08/25/2015
Last updated
08/25/2015
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