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General NPI Number Information
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NPI Number | 1003622259
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Entity Type | Organization
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Legal Business Name | LATINO COMMISSION ON ALCOHOL AND DRUG ABUSE SERVICES OF SAN MATEO COUN
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Dates
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Enumeration Date | 12/03/2024
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Last Update Date | 12/03/2024
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Provider Practice Location Address
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Address Line | 1314 SOUTHGATE AVE
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City | DALY CITY
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State | CA
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Zip | 94015-3937
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Country | US
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Telephone | 650-244-1444
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Fax | 650-244-1447
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Provider Business Mailing Address
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Address Line | 1001 SNEATH LN STE 307
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City | SAN BRUNO
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State | CA
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Zip | 94066-2349
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Country | US
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Telephone | 650-244-1444
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Fax | 650-244-1447
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Authorized Official
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Title or Position | DIRECTOR OF SERVCES
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Name | MR. SALVADOR BLANCAS
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Credential |
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Telephone | 650-244-1444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3245S0500X
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Taxonomy Name | Children's Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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