| NPI | 1942602867 |
|---|---|
| Doing Business As | NO |
| Entity Type | Organization |
| Authorized Contact | RUTH ELLEN WALLACE Owner/Director 530-343-6566 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: CA 040021AN) |
| Enumeration Date | 2014-09-23 |
| Last Update Date | 2014-09-23 |