| NPI | 1972039105 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALISSA R NOURSE Bhs Director 530-694-1816 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: CA LR02471016) |
| Enumeration Date | 2017-05-09 |
| Last Update Date | 2017-05-09 |