| NPI | 1023634862 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFF BEESLEY Executive Director 916-342-4818 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2020-06-17 |
| Last Update Date | 2022-09-07 |