Organization
SANTA CRUZ COMMUNITY COUNSELING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL O'BRIEN (EXECUTIVE DIRECTOR)
(831) 469-1700
Entity
Organization
Contact information
Practice address
640 RODRIGUEZ ST, WATSONVILLE, CA 95076-4212
(831) 722-2471
Mailing address
195 HARVEY WEST BLVD, SANTA CRUZ, CA 95060-2126
(831) 469-1700
(831) 425-1905
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
440001DN
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
440001DN
LICENSE CERTIF DADP
CA
Enumeration date
04/18/2007
Last updated
08/22/2020
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