| NPI | 1033574462 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAD KEVER Quality Assurance 805-540-6532 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 261QC1500X Clinic/Center, Community Health | |
| Enumeration Date | 2015-12-30 |
| Last Update Date | 2024-01-12 |