| NPI | 1104499656 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW TATUM CEO 559-593-9801 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2021-07-22 |
| Last Update Date | 2023-08-15 |