Organization
BREAKING THE CYCLE OF ADDICTION
Active
Other names
BREAKING THE CYCLE OF ADDICTION
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARION CORNELIUS WOLFE JR. MSW/ACSW (PRESIDENT)
(916) 583-1035
Entity
Organization
Contact information
Practice address
6011 STACY AVE, SACRAMENTO, CA 95823-3945
(916) 583-1035
Mailing address
6011 STACY AVE, SACRAMENTO, CA 95823-3945
(916) 583-1035
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1780942334
NPI-PERSONAL
CA
Enumeration date
04/03/2019
Last updated
02/20/2020
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