| NPI | 1750702478 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIER JOHNSON MANGINE AO D Couselor 559-582-4412 |
| Organization Subpart ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator (Licence: CA M1202071247) |
| Enumeration Date | 2013-12-23 |
| Last Update Date | 2013-12-23 |