Organization
COMMUNITY COUNSELING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES LOGAN STATLER (EXECUTIVE DIRECTOR)
(805) 543-7969
Entity
Organization
Contact information
Practice address
1129 MARSH ST, SAN LUIS OBISPO, CA 93401-3323
(805) 543-7969
(805) 543-0859
Mailing address
1129 MARSH ST, SAN LUIS OBISPO, CA 93401-3323
(805) 543-7969
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
08/12/2016
Last updated
08/12/2016
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