NPI | 1457804114 |
---|---|
Entity Type | Organization |
Authorized Contact | TROY DORMAN President 209-575-1580 |
Organization Subpart ? | No |
Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: CA 100095AP) |
Enumeration Date | 2016-07-29 |
Last Update Date | 2016-09-15 |