| NPI | 1124818497 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA MARIE KORSAN Quality Care Manager 805-683-0588 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2025-05-09 |
| Last Update Date | 2025-05-09 |