| NPI | 1760906374 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STAR CANNON Director Of Operations 916-388-9418 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2017-07-26 |
| Last Update Date | 2017-07-26 |