Organization
IN-HOME THERAPEUTIC SERVICES OF SLO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ARTHUR WAYNE FREDERICK LCSW,ACSW,DCSW (EXECUTIVE DIRECTOR)
(805) 441-8843
Entity
Organization
Contact information
Practice address
1788 DONNA AVE, LOS OSOS, CA 93402-2014
(805) 441-8843
(805) 528-6401
Mailing address
PO BOX 6477, LOS OSOS, CA 93412-6477
(805) 441-8843
(805) 528-6401
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LCS10732
CA
Other
Enumeration date
11/11/2010
Last updated
11/23/2010
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