Organization
NCADD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY PRUITT CAS (NCAC)
(916) 922-5110
Entity
Organization
Contact information
Practice address
2143 HURLEY WAY, SUITE 130, SACRAMENTO, CA 95825-3253
(916) 924-5110
(916) 921-1239
Mailing address
2143 HURLEY WAY, SUITE 130, SACRAMENTO, CA 95825-3253
(916) 924-5110
(916) 921-1239
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
I8316110
CA
Other
Enumeration date
03/26/2013
Last updated
03/26/2013
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