Clifford Jack, LSAA is an addiction (substance use disorder) counselor in Farmington, NM. Clifford Jack, LSAA NPI is 1679078851. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a male.
The provider's business location address is:
511 E 20TH ST
FARMINGTON, NM
ZIP 87401-105
Phone: (505) 564-3733
The enumeration date for this NPI number is 3/28/2018 and was last updated on 3/28/2018.