Organization
COUNTY OF SANTA CLARA
Active
Other names
Department of Alcohol and Drug Serices-South County Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT GARNER (DEPARTMENT DIRECTOR)
(408) 792-5680
Entity
Organization
Contact information
Practice address
90 HIGHLAND AVE, SAN MARTIN, CA 95046-9504
(408) 686-2222
Mailing address
976 LENZEN AVE, 3RD FLOOR, SAN JOSE, CA 95126-2737
(408) 792-5680
(408) 947-8702
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM2800X
Methadone Clinic
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
434394
STATE PROVIDER NUMBER
CA
01
—
4394
DRUG MEDI-CAL NUMBER
CA
Enumeration date
02/16/2007
Last updated
07/23/2010
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