| NPI | 1417680273 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES PENIX Owner 925-470-9032 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 251K00000X Public Health or Welfare |
| 251S00000X Community/Behavioral Health | |
| 261QH0100X Clinic/Center Health Service | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2022-07-07 |
| Last Update Date | 2022-07-07 |