| NPI | 1598808610 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY MARIE MEILY Administrators Assistant 209-754-6555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2020-08-22 |