Provider First Line Business Practice Location Address:
2178 JOHNSON AVE
Provider Second Line Business Practice Location Address:
SAN LUIS OBISPO COUNTY MENTAL HEALTH
Provider Business Practice Location Address City Name:
SAN LUIS OBISPO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93401
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-440-7093
Provider Business Practice Location Address Fax Number:
805-461-3687
Provider Enumeration Date:
06/23/2006