Organization
PHASES INTEGRATION PROGRAM, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANA SHATERIAN (OWNER)
(858) 345-7422
Entity
Organization
Contact information
Practice address
810 EMERALD ST, #101, SAN DIEGO, CA 92109-2712
(858) 345-7422
Mailing address
13424 TIVERTON RD, SAN DIEGO, CA 92130-1021
(858) 345-7422
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
07/25/2016
Last updated
07/25/2016
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