Healthcare Provider Details

I. General information

NPI: 1942935317
Provider Name (Legal Business Name): PEOPLE'S SELF-HELP HOUSING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2022
Last Update Date: 07/20/2022
Certification Date: 07/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1060 KENDALL ROAD
SAN LUIS OBISPO CA
93401
US

IV. Provider business mailing address

1060 KENDALL ROAD
SAN LUIS OBISPO CA
93401
US

V. Phone/Fax

Practice location:
  • Phone: 805-540-2498
  • Fax:
Mailing address:
  • Phone: 805-540-2498
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. RICK GULINO JR.
Title or Position: DIRECTOR OF RESIDENT SERVICES
Credential: LCSW
Phone: 805-540-2498