NPI | 1245628411 |
---|---|
Entity Type | Organization |
Authorized Contact | CELESTE CLARK Program Director 916-640-8050 |
Organization Subpart ? | No |
Primary Taxonomy | 261QV0200X Clinic/Center, VA (Licence: ID N-45751) |
Enumeration Date | 2014-12-22 |
Last Update Date | 2014-12-22 |