Provider Demographics
NPI:1427382332
Name:SAN LUIS OBISPO COUNTY AIDS SUPPORT NETWORK
Entity Type:Organization
Organization Name:SAN LUIS OBISPO COUNTY AIDS SUPPORT NETWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:EDITH
Authorized Official - Middle Name:
Authorized Official - Last Name:KAHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-781-3660
Mailing Address - Street 1:PO BOX 12158
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93406-2158
Mailing Address - Country:US
Mailing Address - Phone:805-781-3660
Mailing Address - Fax:805-781-3664
Practice Address - Street 1:1320 NIPOMO ST
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-3935
Practice Address - Country:US
Practice Address - Phone:805-781-3660
Practice Address - Fax:805-781-3664
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-24
Last Update Date:2009-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management