Organization
CRESCENT MOON CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LESLIE WHITE (EXECUTIVE DIRECTOR)
(925) 310-4374
Entity
Organization
Contact information
Practice address
1007 OAK HILL RD STE B, LAFAYETTE, CA 94549-3812
(925) 310-4374
Mailing address
1007 OAK HILL RD STE B, LAFAYETTE, CA 94549-3812
(925) 310-4374
Taxonomy
Speciality
Code
Description
License number
State
261QR0800X
Recovery Care Clinic/Center
Primary
—
—
Other
Enumeration date
11/13/2019
Last updated
11/13/2019
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