| NPI | 1174691554 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLIP COWINGS Director 559-241-0364 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children | |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2018-11-08 |