Organization
EDCA LIFESKILL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID JOHN DEL RIO (EXECUTIVE DIRECTOR)
(530) 622-8193
Entity
Organization
Contact information
Practice address
893 SPRING ST, PLACERVILLE, CA 95667-4437
(530) 622-8193
(530) 622-4017
Mailing address
893 SPRING ST, PLACERVILLE, CA 95667-4437
(530) 622-8193
(530) 622-4017
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Enumeration date
03/05/2007
Last updated
10/31/2011
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