Individual provider · Type 1 NPI

Edna Marie White, RDAT-1 R1221770116

Substance Abuse Rehabilitation Facility · Vallejo, CA

NPI number 1679019152 Active

Practice location

126 Ohio St
Vallejo, CA 94590-5049

Fax (707) 644-5501

Specialties and licenses

TaxonomyCodeLicense
Substance Abuse Rehabilitation Facility Primary 324500000XR1221770116 (CA)

Substance Abuse Rehabilitation Facility: A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

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About NPI 1679019152

Edna Marie White, RDAT-1 R1221770116's National Provider Identifier is 1679019152, issued on Jan 9, 2017. The primary taxonomy on file is Substance Abuse Rehabilitation Facility (324500000X), and the practice location is in Vallejo, CA. The record was last updated on Jan 9, 2017.