NPI | 1285631978 |
---|---|
Entity Type | Organization |
Authorized Contact | LEE ROY TILLMAN Program Director/CEO 707-576-0818 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic (Licence: CA 49-02) |
Enumeration Date | 2005-07-07 |
Last Update Date | 2023-03-07 |