| NPI | 1215204276 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANE T HELDING Executive Director 209-579-1151 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2011-11-18 |
| Last Update Date | 2019-05-28 |