Antioch Substance Abuse Programs
Clinic/Center, Rehabilitation, Substance Use Disorder in Fresno, CA. Organization (NPI-2).
NPI number1649507484
StatusActive
Last updated in NPPESNov 16, 2009
Details
- NPI
- 1649507484
- Entity type
- Organization (NPI-2)
- Legal business name
- Antioch Substance Abuse Programs
- Organization subpart
- No
- Enumeration date
- Nov 16, 2009
- Last updated
- Nov 16, 2009
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QR0405X | Clinic/Center, Rehabilitation, Substance Use Disorder | – | – | Yes |
Practice location
3838 N West AveFresno, CA 93705-2703
Phone 559-307-3482 · Fax 559-294-0303
Mailing address
3838 N West AveFresno, CA 93705-2703
Phone 559-307-3482 · Fax 559-294-0303
Authorized official
Jerome Ester Jackson
President
5593073482
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