Organization
CHRIST ASSOCIATION
Active
Other names
Life Leadership Academy
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID HARTFIELD-DYELS (CEO)
(510) 473-2410
Entity
Organization
Contact information
Practice address
927 AMADOR STREET, VALLEJO, CA 94510
(510) 473-2410
Mailing address
PO BOX 572, BENICIA, CA 94510-0572
(510) 473-2410
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
01/11/2017
Last updated
11/24/2021
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