| NPI | 1316164379 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ESTRELLA L. JOSE Licensee/Admin 209-462-4239 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD1600X Clinic/Center Developmental Disabilities (Licence: CA 100000685) |
| Additional Taxonomies | 261QA0600X Clinic/Center Adult Day Care (Licence: CA 100000685) |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2008-07-14 |