| NPI | 1578976080 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTEN HANSON Program Director 916-391-4294 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2014-06-03 |
| Last Update Date | 2014-06-03 |