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Organization

PROJECT AMEND, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MICHAEL AXELROD CADCII, ICADC, CCPS (EXECUTIVE DIRECTOR)
(805) 782-9600
Entity
Organization

Contact information

Practice address
657 SWEENEY LN, SAN LUIS OBISPO, CA 93401-6719
(805) 782-9600
(805) 782-9602
Mailing address
657 SWEENEY LN, SAN LUIS OBISPO, CA 93401-6719
(805) 782-9600
(805) 782-9602

Taxonomy

Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
400007AN
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
400007AN
DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS
CA
Enumeration date
10/08/2009
Last updated
10/08/2009
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