Organization
VERNON HOLM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VERNON ALBERT HOLM CADDTP # 1367 (ALCOHOL OR OTHER DRUG COUNSELOR)
(909) 592-6897
Entity
Organization
Contact information
Practice address
659 E WALNUT ST, PASADENA, CA 91101-1635
(626) 844-0410
Mailing address
323 W 2ND ST, SAN DIMAS, CA 91773-2029
(909) 592-6897
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
04/29/2008
Last updated
06/17/2008
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