| NPI | 1013338938 |
|---|---|
| Doing Business As | MARY ROLISON, PHD |
| Entity Type | Organization |
| Authorized Contact | MARY D ROLISON Owner 408-513-5107 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: CA LCS12823) |
| Additional Taxonomies | 251B00000X Case Management (Licence: CA LCS12823) |
| 251S00000X Community/Behavioral Health (Licence: CA LCS12823) | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: CA LCS12823) | |
| 302R00000X Health Maintenance Organization (Licence: CA LCS12823) | |
| 305S00000X Point of Service (Licence: CA LCS12823) | |
| Enumeration Date | 2013-12-18 |
| Last Update Date | 2013-12-18 |