NPI | 1043086713 |
---|---|
Entity Type | Organization |
Authorized Contact | JOHNNICO ANDREW MAGANA Clinical Service Technician 209-247-0735 |
Organization Subpart ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
Enumeration Date | 2023-12-04 |
Last Update Date | 2023-12-04 |