| NPI | 1033075387 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYDIA DAMENE TEGEGN Administrator 415-568-7427 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2025-12-30 |
| Last Update Date | 2025-12-30 |