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General NPI Number Information
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NPI Number | 1467871228
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Entity Type | Organization
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Legal Business Name | CRISIS INTERVENTION SERVICES
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Dates
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Enumeration Date | 04/09/2014
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Last Update Date | 04/09/2014
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Provider Practice Location Address
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Address Line | 388 CHORRO ST B
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93405-2318
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Country | US
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Telephone | 805-703-3286
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Fax |
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Provider Business Mailing Address
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Address Line | 388 CHORRO ST B
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93405-2318
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Country | US
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Telephone | 805-703-3286
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Fax |
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Authorized Official
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Title or Position | REGISTERED NURSE
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Name | MR. JOHN JOSLYN
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Credential | RN
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Telephone | 805-703-3286
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 273R00000X
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Taxonomy Name | Psychiatric Hospital Unit
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License Number | 513692
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License Number State | CA
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