| Organization Name: | NDR PACIFIC, INC |
| NPI Number: | 1023403714 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | REINER VINCENT NUSBAUM (ADMINISTRATOR) |
| Mailing Address: | 24482 Caracas St Dana Point |
| State: | CA US |
| Postal Code: | 926291320 |
| Phone Number: | 9492188174 |
| Fax Number: | 8667039903 |
| NPI Enumeration Date: | 03/31/2015 |
| NPI Last Update Date: | 03/31/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 300306AP |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |