| NPI | 1033205588 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA TO Program Coordinator 408-370-9688 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2010-04-21 |