| NPI | 1265769632 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA S JOHNSON Program Administrator 916-421-1184 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2009-11-05 |
| Last Update Date | 2010-03-11 |