| NPI | 1164830501 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT GRAHAM Supervising Physician 559-202-3830 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084A0401X Psychiatry & Neurology Addiction Medicine |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Enumeration Date | 2014-07-29 |
| Last Update Date | 2014-07-29 |