| NPI | 1679802789 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICK HASTINGS Director 619-843-8067 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: CA RI-B0911020953) |
| Additional Taxonomies | 261QM2800X Clinic/Center, Methadone Clinic (Licence: CA 101YA0400X) |
| Enumeration Date | 2009-12-18 |
| Last Update Date | 2009-12-18 |