| NPI | 1184991291 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNN PIMENTEL Deputy Administrator 559-265-4800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children |
| Enumeration Date | 2011-11-18 |
| Last Update Date | 2011-11-18 |