NPI | 1669099743 |
---|---|
Doing Business As | SAN JOAQUIN CONNECT III FSP |
Entity Type | Organization |
Authorized Contact | LORENA LOPEZ Provider Relations Supervisor 510-747-0552 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Enumeration Date | 2020-07-06 |
Last Update Date | 2023-04-19 |