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General NPI Number Information
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NPI Number | 1891906400
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Entity Type | Organization
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Legal Business Name | ST. CLARE'S HOME
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Dates
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Enumeration Date | 05/25/2007
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Last Update Date | 01/08/2009
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Provider Practice Location Address
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Address Line | 2091 E VALLEY PKWY
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City | ESCONDIDO
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State | CA
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Zip | 92027-2743
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Country | US
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Telephone | 760-741-0122
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Fax | 760-741-1241
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Provider Business Mailing Address
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Address Line | 2091 E VALLEY PKWY
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City | ESCONDIDO
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State | CA
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Zip | 92027-2743
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Country | US
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Telephone | 760-741-0122
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Fax | 760-741-1241
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Authorized Official
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Title or Position | DIRECTOR, ALCOHOL AND DRUG PROGRAMS
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Name | TERESA INGRID STEWART-TODD
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Credential | CADC
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Telephone | 760-741-0122
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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 | CERT# I8540305
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License Number State | CA
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