| NPI | 1235631391 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALETTE FARWELL Owner 559-321-1309 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility Substance Abuse Treatment, Children |
| Enumeration Date | 2018-03-05 |
| Last Update Date | 2018-03-05 |