| NPI | 1144366022 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRAMESH PRAKASH SHARMA Director Of Administration 661-313-5503 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: TX 0000078) |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2022-08-30 |