| NPI | 1255910733 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARRY GILLIAM CEO 209-340-7277 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2021-04-03 |
| Last Update Date | 2021-04-03 |