Organization
NCI AFFILIATES, INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRYSTAL NEVOSH M.S. (EXECUTIVE DIRECTOR)
(805) 238-6630
Entity
Organization
Contact information
Practice address
496 LINNE RD, PASO ROBLES, CA 93446-7470
(805) 238-6630
(805) 239-9073
Mailing address
496 LINNE RD, PASO ROBLES, CA 93446-7470
(805) 238-6630
(805) 239-9073
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
CA
Other
Enumeration date
03/28/2012
Last updated
03/29/2012
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