| NPI | 1770002503 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENDRA D DAVIS Owner 530-632-7894 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: CA LCS24637) |
| Enumeration Date | 2017-09-13 |
| Last Update Date | 2022-07-21 |