NPI | 1891260576 |
---|---|
Entity Type | Organization |
Authorized Contact | MATTHEW THOMAS TATUM Authorized Official 559-593-9801 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
Enumeration Date | 2018-10-09 |
Last Update Date | 2022-08-19 |