Organization
TIKVA TREATMENT
Active
Other names
THE HAVEN AT PISMO
Organization subpart
No
Provider details
NPI number
Authorized official
ARI HIRT MBA (CEO)
(310) 502-6991
Entity
Organization
Contact information
Practice address
107 NELSON ST, ARROYO GRANDE, CA 93420-3318
(805) 202-3440
(888) 510-9071
Mailing address
929 HIDDEN PINE LN, ARROYO GRANDE, CA 93420-7143
(805) 202-3440
(888) 510-9071
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
400009AP
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
400009AP
STATE OF CALIFORNIA DEPT OF HEALTH
CA
Enumeration date
08/20/2016
Last updated
08/20/2016
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