| NPI | 1851134142 |
|---|---|
| Doing Business As | ENCHANTED LEGACY WELLNESS AND RECOVERY |
| Entity Type | Organization |
| Authorized Contact | ALINE MARIE BALES Practitioner 925-665-9851 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-06-14 |
| Last Update Date | 2024-09-26 |