| NPI | 1467781013 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY GINTER Director Of State Operations 657-465-9497 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2009-12-10 |
| Last Update Date | 2025-07-08 |