| NPI | 1841640315 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IAN ROY Insurance Director 916-533-4285 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2016-06-15 |
| Last Update Date | 2020-02-19 |