| NPI | 1376380758 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA DONAHUE Director Of Admin Services 707-784-7049 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2400X Clinic/Center, Prison Health |
| Enumeration Date | 2024-07-11 |
| Last Update Date | 2024-08-22 |