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General NPI Number Information
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NPI Number | 1831836667
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Entity Type | Organization
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Legal Business Name | KALI WEST, LLC
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Dates
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Enumeration Date | 05/13/2022
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Last Update Date | 09/29/2023
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Provider Practice Location Address
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Address Line | 3790 VIA DE LA VALLE STE 313
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City | DEL MAR
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State | CA
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Zip | 92014-4252
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Country | US
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Telephone | 760-814-8214
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Fax |
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Provider Business Mailing Address
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Address Line | 3790 VIA DE LA VALLE STE 313
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City | DEL MAR
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State | CA
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Zip | 92014-4252
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Country | US
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Telephone | 760-814-8214
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Fax |
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Authorized Official
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Title or Position | COMPLIANCE
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Name | ASHLEY N AMUNDSON
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Credential | EDD
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Telephone | 760-343-5759
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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