| NPI | 1770616088 |
|---|---|
| Other Name | NIRVANA PROP 36 OP |
| Entity Type | Organization |
| Authorized Contact | DENISE C HUNT Behavioral Health Director 209-525-6225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2020-08-22 |