| NPI | 1962184036 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAUN TUCKER Program Director 559-355-0089 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2023-08-07 |
| Last Update Date | 2023-08-07 |