| NPI | 1639539661 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL EDWARD BAGLEY CFO 209-579-1151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: CA 500009GN) |
| Enumeration Date | 2016-03-03 |
| Last Update Date | 2016-03-03 |