Organization
ETHRIDGE RECOVERY CENTER
Active
Other names
Ethridge
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLARD RICHARD STROUD JR. (COUNSELOR)
(619) 231-6361
Entity
Organization
Contact information
Practice address
405 63RD ST, SAN DIEGO, CA 92114-4237
(619) 231-6361
Mailing address
405 63RD ST, SAN DIEGO, CA 92114-4237
(619) 231-6361
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
09/25/2018
Last updated
09/25/2018
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