| NPI | 1194230086 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONI LEA DICKSON GARCIA Clinician/Coe 209-603-2929 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: CA 102382) |
| Enumeration Date | 2017-12-13 |
| Last Update Date | 2017-12-13 |