| NPI | 1750625505 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WESTON LANGE Company Officer 209-668-6188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities (Licence: CA MFC 51268) |
| Enumeration Date | 2012-11-18 |
| Last Update Date | 2012-11-18 |