| NPI | 1124483540 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GENE RADINO Owner 209-527-9797 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: CA 500004AP) |
| Enumeration Date | 2015-12-30 |
| Last Update Date | 2015-12-30 |