Organization
THE FELLOWSHIP CENTER ALCOHOL SERVICES PROGRAM, INC.
Active
Other names
THE FELLOWSHIP CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
RAYMOND J DICICCIO ASW, LAADC-CA (PROGRAM DIRECTOR)
(760) 745-8478
Entity
Organization
Contact information
Practice address
737 E GRAND AVE, ESCONDIDO, CA 92025-4404
(760) 745-8478
(760) 745-1176
Mailing address
737 E GRAND AVE, ESCONDIDO, CA 92025-4404
(760) 745-8478
(760) 745-1176
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
370009AN
CA
Other
Enumeration date
08/11/2005
Last updated
10/19/2018
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