Provider First Line Business Practice Location Address:
101 AVENIDA SERRA
Provider Second Line Business Practice Location Address:
MAINSTREAM GROUP RECOVERY INC.
Provider Business Practice Location Address City Name:
SAN CLEMENTE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92672-3472
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
949-366-9210
Provider Business Practice Location Address Fax Number:
949-498-5706
Provider Enumeration Date:
11/02/2006