| Diversified Intervention Group | |
|
309 Sequoia St Morro Bay CA 93442-1409 | |
| (805) 602-0681 | |
| Not Available |
| Full Name | Diversified Intervention Group |
|---|---|
| Speciality | Case Management |
| Location | 309 Sequoia St, Morro Bay, California |
| Authorized Official Name and Position | Edward Allen Salan (FOUNDING DIRECTOR) |
| Authorized Official Contact | 8056020681 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Diversified Intervention Group 309 Sequoia St Morro Bay CA 93442-1409 Ph: (805) 602-0681 | Diversified Intervention Group 309 Sequoia St Morro Bay CA 93442-1409 Ph: (805) 602-0681 |
| NPI Number | 1396150074 |
|---|---|
| Provider Enumeration Date | 06/21/2014 |
| Last Update Date | 06/21/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396150074 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 251B00000X | Case Management | (* (Not Available)) | Primary |
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