Organization
EL DORADO COMMUNITY COMMUNITY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORNA L FLORES (ASSISTANT DIRECTOR, SUD SERVICES)
(424) 227-7971
Entity
Organization
Contact information
Practice address
1733 EUCLID AVE, SAN DIEGO, CA 92105-5414
(619) 263-0433
Mailing address
1733 EUCLID AVE, SAN DIEGO, CA 92105-5414
(619) 263-0433
(619) 263-3992
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
3720
CA
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8562
—
CA
Enumeration date
08/20/2015
Last updated
12/31/2019
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