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General NPI Number Information
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NPI Number | 1700302502
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Entity Type | Organization
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Legal Business Name | LATINO COMMISSION ON ALCOHOL AND DRUG ABUSE SERVICES
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Dates
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Enumeration Date | 08/14/2017
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Last Update Date | 08/14/2017
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Provider Practice Location Address
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Address Line | 1612 FIRST ST.
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City | COACHELLA
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State | CA
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Zip | 92236
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Country | US
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Telephone | 760-398-9000
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Fax |
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Provider Business Mailing Address
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Address Line | 1612 1ST ST
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City | COACHELLA
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State | CA
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Zip | 92236-1407
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | ROBERT JONES
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Credential | LCSW
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Telephone | 760-398-9000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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