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General NPI Number Information
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NPI Number | 1003063892
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Entity Type | Organization
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Legal Business Name | NORTH COUNTY LIFELINE
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Dates
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Enumeration Date | 08/22/2008
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Last Update Date | 08/22/2008
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Provider Practice Location Address
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Address Line | 707 OCEANSIDE BLVD
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City | OCEANSIDE
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State | CA
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Zip | 92054-5225
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Country | US
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Telephone | 760-726-4900
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Fax | 760-631-0778
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Provider Business Mailing Address
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Address Line | 707 OCEANSIDE BLVD
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City | OCEANSIDE
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State | CA
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Zip | 92054-5225
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Country | US
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Telephone | 760-726-4900
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Fax | 760-631-0778
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Authorized Official
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Title or Position | DRIECTOR OF BEHAVIORAL HEALTH
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Name | DEBORAH M SHRIVER
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Credential | MA, LMFT
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Telephone | 760-757-0118
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | DMH 37EC
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License Number State | CA
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