| NPI Details | |
|---|---|
| NPI | 1053524405 |
| Enumeration Date | 05/08/2007 |
| Last Updated | 10/28/2014 |
| Entity Type | Healthcare Provider |
| Active | Over 11 years ago |
| Authorized Information | |
|---|---|
| Name | DWAYNE ANTHONY DWAYNE |
| Position | EXECUTIVE DIRECTOR |
| Phone | (661) 845-3753 |
| Fax | (661) 845-4866 |
| Practice Location | |
|---|---|
| 10420 MAIN ST LAMONT CA, 93241-1727, US |
|
| Phone | (661) 845-3753 |
| Fax | (661) 845-4866 |
| Business Location | |
|---|---|
| PO BOX 3067 BAKERSFIELD CA, 93385, US |
|
| Phone | (661) 845-3753 |
| Fax | (661) 845-4866 |
| Toxanomy | |
|---|---|
| Taxonomy Code | 251S00000X |
| License State | |
| License Number | |
| Remove 1053524405 NPI Number | |
According to our database, Community Service Organization Behavioral Health Programs NPI is 1053524405, taxonomy code is 251S00000X Community Service Organization Behavioral Health Programs physically located at 10420 Main St, Lamont CA, 93241-1727. NPI Number 1033115704 has the healthcare provider type.
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1053524405 NPI number is provided on an as is basis without warranty of any kind. 1053524405 is maintained by the National Plan & Provider Enumeration System. The contents of Community Service Organization Behavioral Health Programs are for informational purposes only.
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