| NPI | 1992498521 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CORY RENNEY Director Of Compliance 530-208-9447 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251X00000X Supports Brokerage |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| Enumeration Date | 2023-05-30 |
| Last Update Date | 2025-09-15 |