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General NPI Number Information
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NPI Number | 1568602761
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Entity Type | Organization
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Legal Business Name | THE EFFORT DETOX
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Dates
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Enumeration Date | 02/27/2009
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Last Update Date | 02/27/2009
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Provider Practice Location Address
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Address Line | 7586 STOCKTON BLVD 7586 STOCKTON BLVD.
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City | SACRAMENTO
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State | CA
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Zip | 95823-3923
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Country | US
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Telephone | 916-405-4600
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Fax | 916-405-4620
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Provider Business Mailing Address
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Address Line | 7586 STOCKTON BLVD 7586 STOCKTON BLVD.
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City | SACRAMENTO
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State | CA
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Zip | 95823-3923
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Country | US
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Telephone | 916-405-4600
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Fax | 916-405-4620
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Authorized Official
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Title or Position | COUNCELOR
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Name | MS. SUSAN THERESA HANSON
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Credential | RASI
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Telephone | 916-405-4600
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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 |
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License Number State |
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