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General NPI Number Information
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NPI Number | 1457407322
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Entity Type | Organization
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Legal Business Name | IMPERIAL COUNTY BEHAVIORAL HEALTH SERVICES-ALCOHOL AND DRUG PROGRAMS
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1295 W STATE ST
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City | EL CENTRO
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State | CA
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Zip | 92243-2845
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Country | US
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Telephone | 760-337-7847
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Fax |
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Provider Business Mailing Address
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Address Line | 298 E ORANGE AVE
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City | EL CENTRO
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State | CA
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Zip | 92243-2712
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Country | US
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Telephone | 760-353-8548
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Fax |
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Authorized Official
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Title or Position | SUBSTANCE ABUSE COUNSELOR II
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Name | MRS. ESTHER OCHOA CASTILLO
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Credential |
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Telephone | 760-337-7847
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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