| NPI | 1205584299 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ATONYA MOORE Program Manager 559-852-2210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare |
| Additional Taxonomies | 251X00000X Supports Brokerage |
| Enumeration Date | 2022-03-17 |
| Last Update Date | 2022-03-18 |