| NPI | 1982126710 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ESTELLETTA WASHINGTON Owner 209-688-8701 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2017-07-13 |
| Last Update Date | 2022-07-21 |