Organization
NARCONON FRESH START
Active
Other names
Narconon Southern California
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON FARNSWORTH (VP ADMINISTRATION)
(323) 871-8644
Entity
Organization
Contact information
Practice address
17123 ROUNDHILL DRIVE, HUNTINGTON BEACH, CA 92649
(323) 871-8644
(818) 500-0542
Mailing address
225 W BROADWAY, SUITE 420, GLENDALE, CA 91204-1331
(323) 871-8644
(818) 500-0542
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
3000077AN; 370087AN
CA
Other
Enumeration date
10/25/2006
Last updated
05/17/2012
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