| NPI | 1750738142 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN RICHARD DURBIN Program Manager 916-453-2704 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: CA Aii8741214) |
| Enumeration Date | 2016-05-16 |
| Last Update Date | 2016-05-16 |