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Jack Coleman JR.
Addiction (Substance Use Disorder) Counselor in Long Beach, California
NPI 1114146156

Jack Coleman JR. is an Addiction (Substance Use Disorder) Counselor based in Long Beach, CA and is specialized in Addiction (Substance Use Disorder). Jack Coleman JR. practices in Long Beach, CA. The NPI Number for Jack Coleman JR. is 1114146156 and holds a License No. (California).

The current practice location address for Jack Coleman JR. is 944 Pacific Ave, Long Beach, CA and can be reached out via phone at 562-436-3533.

Location: 944 Pacific Ave, Long Beach, CA, 90813-4228
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1114146156
Provider Name
Jack Coleman JR.
Credential
Provider Entity Type
Individual
Gender
Male
Address
944 Pacific Ave, Long Beach, CA, 90813-4228
Phone Number
562-436-3533
Fax Number
Provider Enumeration Date
04/25/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
7006 05 CA
institution
Provider Business Practice Location Address Details
Address
944 Pacific Ave
City
Long Beach
State
California
Zip
90813-4228
Phone Number
562-436-3533
Fax Number
person
Provider Business Mailing Address Details
Address
944 Pacific Ave
City
Long Beach
State
California
Zip
90813-4228
Phone Number
562-436-3533
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
()
Definition
Definition to come...
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