Organization
COUNTY OF SAN LUIS OBISPO
Active
Organization
COUNTY OF SAN LUIS OBISPO
Active
Other names
MORRO BAY HIGH SCHOOL
Organization subpart
No
Provider details
NPI number
Authorized official
M. DAISY ILANO M.D. (MEDICAL DIRECTOR)
(805) 781-4700
Entity
Organization
Contact information
Practice address
235 ATASCADERO RD, MORRO BAY, CA 93442-1516
(805) 781-4700
(805) 781-1273
Mailing address
2178 JOHNSON AVE, SAN LUIS OBISPO, CA 93401-4535
(805) 781-4700
(805) 781-1273
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
CA
Other
Enumeration date
11/15/2011
Last updated
09/24/2014
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