Clean & Sober Detox a California Nonprofit Corporation
NPI #1255317145 in Fair Oaks, California
Provider Information
- NPI Number
- 1255317145
- Entity Type
- Organization
- Organization Name
- Clean & Sober Detox a California Nonprofit Corporation
- Primary Specialty
- Substance Abuse Rehabilitation Facility
- Enumeration Date
- Dec 21, 2005
- Last Updated
- Aug 17, 2018
Practice Location
- Address
- 8946 MADISON AVE
- City
- Fair Oaks
- State
- California
- ZIP Code
- 95628
- Phone
- (916) 965-3386
Authorized Official
- Name
- MARYL RUSSO
- Title
- FACILITIES ADMIN
- Phone
- (916) 273-4537
Specialties & Taxonomy Codes
| Specialty |
|---|
| Substance Abuse Rehabilitation Facility |
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