| NPI | 1124587233 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY GINTER Director Of State Operations 657-465-9497 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2019-03-18 |
| Last Update Date | 2024-06-03 |