Organization
COLUMBINE COUNSELING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN JACK POOL MFT (OWNER)
(209) 586-6868
Entity
Organization
Contact information
Practice address
22984 TWAIN HARTE DRIVE, TWAIN HARTE, CA 95383
(209) 586-6868
Mailing address
PO BOX 1477, TWAIN HARTE, CA 95383-1477
(209) 586-6868
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
MFT30749
CA
Other
Enumeration date
02/19/2009
Last updated
02/19/2009
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