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General NPI Number Information
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NPI Number | 1164652699
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Entity Type | Organization
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Legal Business Name | GROUP CONSCIENCE, INC.
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Dates
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Enumeration Date | 07/17/2009
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Last Update Date | 07/17/2009
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Provider Practice Location Address
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Address Line | 1482 KINGS VILLA RD
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City | RAMONA
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State | CA
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Zip | 92065-1042
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Country | US
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Telephone | 760-789-8070
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Fax | 760-789-8078
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Provider Business Mailing Address
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Address Line | PO BOX 1878
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City | RAMONA
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State | CA
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Zip | 92065-0920
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Country | US
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Telephone | 760-789-8070
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Fax | 760-789-8078
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. CONNIE COLLINS
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Credential | L.C.S.W.
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Telephone | 760-789-8070
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | 370025AN
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License Number State | CA
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