| NPI | 1174912547 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARYELLEN PISTALU Director Contract Compliance 559-251-4800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2015-01-22 |
| Last Update Date | 2015-01-22 |