Provider First Line Business Practice Location Address:
SUBSTANCE ABUSE COUNSELING CTR
Provider Second Line Business Practice Location Address:
4025 TRIPOLI AVENUE, BLDG 14
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92140-5000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-524-1912
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/27/2012