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General NPI Number Information
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NPI Number | 1639640212
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Entity Type | Organization
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Legal Business Name | CROWNVIEW CO-OCCURRING INSTITUTE
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Dates
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Enumeration Date | 12/07/2018
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Last Update Date | 12/07/2018
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Provider Practice Location Address
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Address Line | 212 N CLEMENTINE ST
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City | OCEANSIDE
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State | CA
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Zip | 92054-2805
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Country | US
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Telephone | 760-231-1170
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Fax | 760-231-5303
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Provider Business Mailing Address
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Address Line | 315 N CLEMENTINE ST
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City | OCEANSIDE
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State | CA
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Zip | 92054-2806
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Country | US
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Telephone | 760-231-1170
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Fax | 760-231-5303
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | JEFFREY KLEIN
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Credential |
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Telephone | 760-231-1170
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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