| NPI | 1043587488 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA SHEPARD Program Coordinator 510-839-3769 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2011-11-30 |
| Last Update Date | 2019-06-18 |