Organization
BEHAVIORAL HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELOISA DUENAS CUENCA (PROGRAM DIRECTOR)
(310) 679-9126
Entity
Organization
Contact information
Practice address
505 S PACIFIC AVE, SAN PEDRO, CA 90731-2656
(310) 831-2358
(310) 831-2830
Mailing address
505 S PACIFIC AVE, SAN PEDRO, CA 90731-2656
(310) 831-2358
(310) 831-2830
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
95-283-8006
CA
Other
Enumeration date
03/08/2012
Last updated
03/29/2012
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