| NPI | 1588387526 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NINA BOLING Chief Executive Officer 209-884-2424 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center Developmental Disabilities |
| Enumeration Date | 2022-09-23 |
| Last Update Date | 2024-08-29 |