| NPI | 1184231508 |
|---|---|
| Other Name | THE LODGE |
| Entity Type | Organization |
| Authorized Contact | KATHRYN WILBUR Executive Director 559-492-1373 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 251X00000X Supports Brokerage | |
| 385H00000X Respite Care | |
| Enumeration Date | 2020-09-29 |
| Last Update Date | 2024-03-12 |