| NPI | 1447524921 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLAUDE VERNON COLEMAN Admenistrator 707-407-0540 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: CA G86543) |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services (Licence: CA 16089) |
| Enumeration Date | 2012-03-01 |
| Last Update Date | 2012-03-01 |