| NPI | 1467959155 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON VANCE Owner 530-966-5454 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 314000000X Skilled Nursing Facility |
| Enumeration Date | 2018-04-09 |
| Last Update Date | 2022-07-14 |