| NPI | 1235633173 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | DANITA LYNN SANDS President 916-532-4044  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: CA 310023BP)  | 
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | 
| Enumeration Date | 2018-03-23 | 
| Last Update Date | 2022-04-21 |