| NPI | 1518183243 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANK BRITO Nurse 909-625-3818 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic (Licence: CA 3613) |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2020-08-22 |