| NPI | 1700203502 |
|---|---|
| Doing Business As | STOCKTON PRISON CHCF |
| Entity Type | Organization |
| Authorized Contact | NICOLE CLARKE Assistant Regional Revenue Manager 949-930-6874 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment |
| Enumeration Date | 2014-03-19 |
| Last Update Date | 2014-03-19 |