Villa Oasis San Diego Iop INC
Clinic/Center, Rehabilitation, Substance Use Disorder in San Diego, CA. Organization (NPI-2).
NPI number1003663410
StatusActive
Last updated in NPPESJan 2, 2025
Details
- NPI
- 1003663410
- Entity type
- Organization (NPI-2)
- Legal business name
- Villa Oasis San Diego Iop INC
- Organization subpart
- No
- Enumeration date
- May 2, 2024
- Certification date
- Jan 2, 2025
- Last updated
- Jan 2, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QR0405X | Clinic/Center, Rehabilitation, Substance Use Disorder | – | – | Yes |
| 261QM0850X | Clinic/Center, Adult Mental Health | – | – |
Practice location
16516 Bernardo Center Dr Ste 130San Diego, CA 92128-2575
Phone 562-413-5216
Mailing address
Po Box 18463Anaheim, CA 92817-8463
Phone 562-413-5216
Authorized official
Jesse Cook
Program Director
9516758198
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