Provider First Line Business Practice Location Address:
1125 E. CLARK AVE
Provider Second Line Business Practice Location Address:
COAST VALLEY SUBSTANCE ABUSE TREATMENT CENTER
Provider Business Practice Location Address City Name:
ORCUTT
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93455
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
505-739-1512
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/25/2012