Provider First Line Business Practice Location Address:
1800 H ST
Provider Second Line Business Practice Location Address:
MAIN OFC/COUNSELING RM
Provider Business Practice Location Address City Name:
UNION CITY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94587-3321
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-471-2520
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/30/2017