| NPI | 1043348485 |
|---|---|
| Other Name | CHILDREN'S INTENSIVE COMMUNITY SUPPORT |
| Entity Type | Organization |
| Authorized Contact | TONY VARTAN Behavioral Health Director 209-525-6225 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2024-04-30 |