| NPI | 1811719438 |
|---|---|
| Other Name | SOAP MAT, LLC CENTRAL |
| Entity Type | Organization |
| Authorized Contact | FRANCISCO MARC GONZALO Regional Director 760-305-7528 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic |
| Enumeration Date | 2024-10-25 |
| Last Update Date | 2024-11-20 |