| NPI | 1174724884 |
|---|---|
| Other Name | FEE FOR SERVICE - LCSW |
| Entity Type | Organization |
| Authorized Contact | RUBEN IMPERIAL Behavioral Health Interim Director 209-525-6225 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2019-10-11 |