Organization
NEW ORIGINS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD HONN CATC III (PROGRAM ADMINISTRATOR)
(909) 233-5634
Entity
Organization
Contact information
Practice address
101 E REDLANDS BLVD, STE 200, REDLANDS, CA 92373-4775
(909) 233-5634
Mailing address
PO BOX 3610, BLUE JAY, CA 92317-3610
(909) 233-5634
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
106H00000X
Marriage & Family Therapist
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
04/13/2015
Last updated
11/30/2015
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