| NPI | 1053972885 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY MEILY Bhs Program Manager 209-754-6516 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2019-06-24 |
| Last Update Date | 2019-06-24 |