| NPI | 1972924637 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA ROGERS Regional Director 559-582-4881 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251X00000X Supports Brokerage |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| Enumeration Date | 2013-12-26 |
| Last Update Date | 2023-05-08 |