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Organization

EVANS LANE WELLNESS AND RECOVERY CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. SHERRY JOHNSON (LICENSED CLINICAL SUPERVISOR)
(408) 793-2424
Entity
Organization

Contact information

Practice address
2090 EVANS LN, SAN JOSE, CA 95125-2072
(408) 793-2406
Mailing address
2090 EVANS LN, SAN JOSE, CA 95125-2072
(408) 793-2406

Taxonomy

Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary

Other

Enumeration date
09/24/2009
Last updated
09/24/2009
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