| South Bay Connect Treatment Center | |
|
916 N Western Ave Ste 210 San Pedro CA 90732-2407 | |
| (310) 776-7406 | |
| Not Available |
| Full Name | South Bay Connect Treatment Center |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 916 N Western Ave Ste 210, San Pedro, California |
| Authorized Official Name and Position | Alicia Ann Macgowan (FOUNDER) |
| Authorized Official Contact | 3107767406 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| South Bay Connect Treatment Center 916 N Western Ave Suite 210 San Pedro CA 90732-2435 Ph: (310) 776-7406 | South Bay Connect Treatment Center 916 N Western Ave Ste 210 San Pedro CA 90732-2407 Ph: (310) 776-7406 |
| NPI Number | 1346790730 |
|---|---|
| Provider Enumeration Date | 10/10/2016 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346790730 | NPI | - | NPPES |
| 1619157716 | Other | CA | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 21303 (California) | Primary |
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