Organization
BAY AREA TEENS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. GILLIAN AUGUST-THORP M.A. (OWNER, MANAGING MEMBER)
(408) 705-5200
Entity
Organization
Contact information
Practice address
1203 LAS PALMAS DR, SANTA CLARA, CA 95051-3923
(408) 705-5200
Mailing address
2634 MAPLEWOOD LN, SANTA CLARA, CA 95051-6235
(408) 705-5200
Taxonomy
Speciality
Code
Description
License number
State
3245S0500X
Children's Substance Abuse Rehabilitation Facility
Primary
435202483
CA
Other
Enumeration date
11/12/2014
Last updated
11/12/2014
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