Organization
KOOL LIVING INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLAS RUSSI (CEO)
(951) 427-4807
Entity
Organization
Contact information
Practice address
449 AVENIDA CRESPI, SAN CLEMENTE, CA 92672-3331
(951) 427-4807
Mailing address
20138 ELKWOOD ST, WINNETKA, CA 91306-2312
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
300332CP
CA
Other
Enumeration date
09/18/2015
Last updated
11/06/2017
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