| NPI | 1972005635 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHEILA TAYLOR Administrator 661-213-6798 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: CA 157202828) |
| Additional Taxonomies | 251S00000X (Licence: CA 157804881) |
| 251S00000X (Licence: CA 157201493) | |
| Enumeration Date | 2018-03-08 |
| Last Update Date | 2018-03-17 |