| NPI | 1750865804 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARSHALL STENSON Business Services Director 916-442-4985 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic |
| Enumeration Date | 2018-09-24 |
| Last Update Date | 2023-12-08 |