| NPI | 1255317145 |
|---|---|
| Doing Business As | CLEAN & SOBER DETOX |
| Entity Type | Organization |
| Authorized Contact | MARYL RUSSO Facilities Admin 916-273-4537 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: CA 340067AN) |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2018-08-17 |