NPI | 1033631718 |
---|---|
Doing Business As | SOCO DBT |
Entity Type | Organization |
Authorized Contact | COURTNEY WESTIN Owner 949-524-1509 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X |
Additional Taxonomies | 305R00000X Preferred Provider Organization |
Enumeration Date | 2017-07-13 |
Last Update Date | 2022-07-21 |