Provider Demographics
NPI:1386855393
Name:SAN LUIS OBISPO COUNTY DRUG & ALCOHOL
Entity Type:Organization
Organization Name:SAN LUIS OBISPO COUNTY DRUG & ALCOHOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIALIST II
Authorized Official - Prefix:MR
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:O'CONNOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-461-6233
Mailing Address - Street 1:3556 EL CAMINO REAL
Mailing Address - Street 2:
Mailing Address - City:ATASCADERO
Mailing Address - State:CA
Mailing Address - Zip Code:93422-2532
Mailing Address - Country:US
Mailing Address - Phone:805-461-6080
Mailing Address - Fax:805-461-6114
Practice Address - Street 1:1028 PACIFIC ST
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-3651
Practice Address - Country:US
Practice Address - Phone:805-544-3594
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health