| NPI | 1053702787 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDSAY FERGUSON Director 415-215-1858 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: CA 01131697) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 03131697) |
| Enumeration Date | 2015-02-17 |
| Last Update Date | 2015-02-17 |