| NPI | 1396371720 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW THOMAS TATUM Owner 559-567-3912 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2020-03-17 |
| Last Update Date | 2021-08-19 |