| NPI | 1013441898 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN M HUDSON Clinician 209-675-0144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CA LCSW#74320) |
| Enumeration Date | 2017-04-18 |
| Last Update Date | 2017-04-25 |