| NPI | 1710373808 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE DEANNE BLANCHARD Office Manager 209-579-3301 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2015-04-15 |
| Last Update Date | 2015-04-15 |