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TRAVIS BANKS CADC L
Addiction (Substance Use Disorder) >> Counselor >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1437568797
Individual Registrant: TRAVIS BANKS CADC L
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
1055 W HENDERSON AVE PORTERVILLE, CA 93257-1490 US
Tel: 559-788-1500 Fax: --
Tel: 559-788-1500 Fax: --
Contact information for business:
1055 W HENDERSON AVE PORTERVILLE, CA 93257-1490 US
Tel: 559-788-1500 Fax: --
Tel: 559-788-1500 Fax: --
Registration Information:
NPI: 1437568797
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 101YA0400X | Behavioral Health & Social Service Providers Counselor Addiction (Substance Use Disorder) | CA | CI22110919 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
