Individual provider · Type 1 NPI
Dominique Keenan, RADT-I
Substance Abuse Rehabilitation Facility · Sacramento, CA
Practice location
1550 Juliesse Ave
Sacramento, CA 95815-1803
Fax (916) 921-6604
Mailing address
1550 Juliesse Avenue
Sacramento, CA 95815
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Substance Abuse Rehabilitation Facility Primary | 324500000X | None listed |
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 1811447063
Dominique Keenan, RADT-I's National Provider Identifier is 1811447063, issued on Oct 12, 2016. The primary taxonomy on file is Substance Abuse Rehabilitation Facility (324500000X), and the practice location is in Sacramento, CA. The record was last updated on Oct 12, 2016.