Organization
AMERICAN INDIAN CHANGING SPIRITS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HENRY VAN OUDHEUSDEN M.A., M.S.W. (PRESIDENT/CEO)
(310) 679-9126
Entity
Organization
Contact information
Practice address
2120 W WILLIAMS ST, BUILDING #2, LONG BEACH, CA 90810-3636
(562) 388-8118
(562) 388-8117
Mailing address
2120 W WILLIAMS ST, BUILDING #1, LONG BEACH, CA 90810-3636
(562) 388-8118
(562) 388-8117
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
190239AN
CA
Other
Enumeration date
10/31/2013
Last updated
10/31/2013
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