Organization
SHARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLESTER MARTIN (BILLER/CODER)
(775) 745-8276
Entity
Organization
Contact information
Practice address
615 N ST, BAKERSFIELD, CA 93304-2152
(661) 369-9595
Mailing address
615 N ST, BAKERSFIELD, CA 93304-2152
(661) 369-9595
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
174200000X
Meals Provider
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
347C00000X
Private Vehicle
—
—
Other
Enumeration date
06/02/2023
Last updated
06/02/2023
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