| NPI | 1104247659 |
|---|---|
| Doing Business As | KICKSTART |
| Entity Type | Organization |
| Authorized Contact | TRACY GINTER Director Of State Operations 657-465-9497 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2013-12-31 |
| Last Update Date | 2024-07-16 |