| NPI | 1194808584 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FAYE ETTA GEORGE Counselor Ll 916-391-4192 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 4986) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2020-08-22 |