Healthcare Provider Details

I. General information

NPI: 1689179533
Provider Name (Legal Business Name): COMMUNITY ACTION PARTNERSHIP OF SAN LUIS OBISPO COUNTY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2018
Last Update Date: 03/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1345 OAK ST
PASO ROBLES CA
93446-2240
US

IV. Provider business mailing address

2475 JOHNSON AVE
SAN LUIS OBISPO CA
93401-5349
US

V. Phone/Fax

Practice location:
  • Phone: 805-544-4355
  • Fax:
Mailing address:
  • Phone: 805-546-0950
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number405801854
License Number StateCA

VIII. Authorized Official

Name: JOEL DIRINGER
Title or Position: COMPLIANCE OFFICER
Credential:
Phone: 805-546-0950