| NPI | 1043602063 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA LEE LENNEMAN Owner 408-482-2539 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MT SWP-LCSW LIC-8029) |
| Enumeration Date | 2015-02-27 |
| Last Update Date | 2015-02-27 |