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NPI Code Detail

MEDICARE: MS. HOPE MARIE MCCALLISTER C.A.D.C.

MEDICARE: MS. HOPE MARIE MCCALLISTER C.A.D.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1912048315
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. HOPE MARIE MCCALLISTER C.A.D.C.
Provider Business Mailing Address
First Line : 218 REDONDO AVE
Second Line : APT 7
City : LONG BEACH
State : CA
Zip : 90803-5903
Country : US
Telephone Number : 562-331-1893
Fax Number :
Provider Business Practice Location Address
First Line : 1322 N AVALON BLVD
Second Line :
City : WILMINGTON
State : CA
Zip : 90744-2639
Country : US
Telephone Number : 310-513-1300
Fax Number : 310-513-1311
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2007
Last Update Date : 07/08/2007

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