Organization
DESIRE 4 CHANGE LIVING IOP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KIMBERLEE SAFFORE (EXECUTIVE PROGRAM DIRECTOR)
(310) 345-9618
Entity
Organization
Contact information
Practice address
17019 SAN JOSE ST, GRANADA HILLS, CA 91344-6238
(310) 345-9618
Mailing address
17019 SAN JOSE ST, GRANADA HILLS, CA 91344-6238
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
02/01/2017
Last updated
04/06/2017
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