| NPI | 1831478148 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE KIRKPATRICK Program Manager 707-472-2621 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251K00000X Public Health or Welfare |
| Additional Taxonomies | 261QP0904X Clinic/Center, Public Health, Federal |
| 261QP0905X Clinic/Center, Public Health, State or Local | |
| Enumeration Date | 2011-08-04 |
| Last Update Date | 2011-08-04 |