| NPI | 1023167541 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON A BAILEY Fiscal Support Supervisor 661-868-0304 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251K00000X Public Health or Welfare (Licence: CA CLE1134) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2025-10-07 |